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NPI Code Detail

MEDICARE: QUEST PROVIDER SERVICES

MEDICARE: QUEST PROVIDER 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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1669848545
Entity Type Code : Organization
Provider Name (Legal Business Name) : QUEST PROVIDER SERVICES
Provider Business Mailing Address
First Line : 2329 E WT HARRIS BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-5186
Country : US
Telephone Number : 704-537-4730
Fax Number :
Provider Business Practice Location Address
First Line : 2329 E WT HARRIS BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28213-5186
Country : US
Telephone Number : 704-537-4730
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. KATELYNN BAKER
Credential :
Telephone Number : 704-537-4730
Provider Enumeration Date : 08/14/2015
Last Update Date : 08/14/2015

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Directions to “QUEST PROVIDER SERVICES ” Practice Location

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