MEDICARE: QUIET MAN HOLDINGS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	363LF0000X	Family Nurse Practitioner
3	363LG0600X	Gerontology Nurse Practitioner

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	:	1407739378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUIET MAN HOLDINGS LLC

Provider Business Mailing Address
First Line	:	25 WASHINGTON LN STE 8A
Second Line	:
City	:	WYNCOTE
State	:	PA
Zip	:	19095-1400
Country	:	US
Telephone Number	:	215-318-5510
Fax Number	:	215-491-7258

Provider Business Practice Location Address
First Line	:	25 WASHINGTON LN STE 8A
Second Line	:
City	:	WYNCOTE
State	:	PA
Zip	:	19095-1400
Country	:	US
Telephone Number	:	215-318-5510
Fax Number	:	215-491-7258

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERALD DRISCOLL
Credential	:	NP
Telephone Number	:	215-290-0095

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	01/08/2026

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