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General NPI Number Information
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NPI Number | 1356679880
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Entity Type | Organization
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Legal Business Name | QUALICARE OF GRAHAM LLC
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 11/20/2009
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Provider Practice Location Address
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Address Line | 750 TALLULAH RD
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City | ROBBINSVILLE
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State | NC
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Zip | 28771-9461
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Country | US
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Telephone | 828-479-4790
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 789
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City | ROBBINSVILLE
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State | NC
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Zip | 28771-0789
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Country | US
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Telephone | 828-479-4790
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MS. POLLY ANN BUCHANAN
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Credential |
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Telephone | 828-479-4790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HC2553
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License Number State | NC
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