MEDICARE: QUICKCARE OF ALABAMA 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1790363083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUICKCARE OF ALABAMA LLC

Provider Business Mailing Address
First Line	:	2002 OKLAHOMA ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36107-1034
Country	:	US
Telephone Number	:	334-471-9486
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 OKLAHOMA ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36107-1034
Country	:	US
Telephone Number	:	334-471-9486
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS KALISHA MARIE MADISON
Credential	:
Telephone Number	:	334-471-9486

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	04/03/2021

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