MEDICARE: QUANTUM LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306960943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUANTUM LLC

Provider Business Mailing Address
First Line	:	595 CHAPEL HILLS DR
Second Line	:	STE 301
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-955-1237
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 CHAPEL HILLS DR
Second Line	:	STE 301
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1022
Country	:	US
Telephone Number	:	719-955-1237
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. HEATHER LEIGH BARBISH
Credential	:
Telephone Number	:	719-598-8213

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/22/2013

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Directions to “QUANTUM LLC ” Practice Location

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