Healthcare Provider Details

I. General information

NPI: 1861276164
Provider Name (Legal Business Name): QC'S CARE PROVIDER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2449 PARKWOOD AVE
COLUMBUS OH
43211-1843
US

IV. Provider business mailing address

2449 PARKWOOD AVE
COLUMBUS OH
43211-1843
US

V. Phone/Fax

Practice location:
  • Phone: 614-634-1506
  • Fax:
Mailing address:
  • Phone: 614-634-1506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SHAVONA RICCARDA BARNES
Title or Position: OWNER
Credential:
Phone: 614-634-1506