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General NPI Number Information
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NPI Number | 1174886980
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Entity Type | Organization
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Legal Business Name | TRISTATE QUALITY CARE CORP
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 7202 FORDSON RD
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City | ALEXANDRIA
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State | VA
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Zip | 22306-7217
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Country | US
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Telephone | 202-629-8573
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Fax |
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Provider Business Mailing Address
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Address Line | 7202 FORDSON RD
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City | ALEXANDRIA
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State | VA
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Zip | 22306-7217
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Country | US
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Telephone | 202-629-8573
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HISHAM RADWAN
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Credential |
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Telephone | 703-665-3566
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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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