Healthcare Provider Details

I. General information

NPI: 1891552774
Provider Name (Legal Business Name): QRC ALASKA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4226 PENRITH CT
DUBLIN OH
43016-8276
US

IV. Provider business mailing address

4226 PENRITH CT
DUBLIN OH
43016-8276
US

V. Phone/Fax

Practice location:
  • Phone: 740-994-1811
  • Fax: 740-888-0306
Mailing address:
  • Phone: 740-994-1811
  • Fax: 740-888-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LIANE PARKER
Title or Position: CNO
Credential: RN CPHM
Phone: 740-994-1811