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General NPI Number Information
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NPI Number | 1144700154
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Entity Type | Organization
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Legal Business Name | QUAD HOME HEALTH
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Dates
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Enumeration Date | 08/19/2018
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Last Update Date | 08/19/2018
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Provider Practice Location Address
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Address Line | 202 GOSHAWK CT
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City | SUFFOLK
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State | VA
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Zip | 23435-3725
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Country | US
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Telephone | 757-414-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 BRIDGE RD PMB 191
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | KIMBERLY L FIELDS
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Credential |
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Telephone | 757-414-3733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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