Healthcare Provider Details

I. General information

NPI: 1134562259
Provider Name (Legal Business Name): QUALITY CARE FOR LIFE L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 EFFINGTON LN
COLUMBUS OH
43207-5337
US

IV. Provider business mailing address

356 EFFINGTON LN
COLUMBUS OH
43207-5337
US

V. Phone/Fax

Practice location:
  • Phone: 614-409-3800
  • Fax:
Mailing address:
  • Phone: 614-409-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberRT96400
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberRT296400
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License NumberRT296400
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberRT296400
License Number StateOH

VIII. Authorized Official

Name: NICOLE JENNINGS
Title or Position: OWNER
Credential:
Phone: 614-409-3800