MEDICARE: QUALITY IMPROVEMENT SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		NC
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1225206915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY IMPROVEMENT SERVICES

Provider Business Mailing Address
First Line	:	543 COX RD STE B-6
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0607
Country	:	US
Telephone Number	:	704-460-3399
Fax Number	:	704-691-7127

Provider Business Practice Location Address
First Line	:	543 COX RD STE B-6
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-0607
Country	:	US
Telephone Number	:	704-460-3399
Fax Number	:

Authorized Official
Title or Position	:	EXECTIVE DIRECTOR
Name	:	MRS. TAMMY R HARRELL
Credential	:	QDDP
Telephone Number	:	704-460-3399

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	04/21/2010

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Directions to “QUALITY IMPROVEMENT SERVICES ” Practice Location

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