Healthcare Provider Details

I. General information

NPI: 1710894233
Provider Name (Legal Business Name): QUALITY CARE MEDICAL CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 CALHOUN ST
GALAX VA
24333-3840
US

IV. Provider business mailing address

106 CALHOUN ST
GALAX VA
24333-3840
US

V. Phone/Fax

Practice location:
  • Phone: 276-237-7251
  • Fax: 276-601-2587
Mailing address:
  • Phone: 276-237-7251
  • Fax: 276-601-2587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JACQUELYN FOX
Title or Position: OWNER
Credential:
Phone: 276-237-7251