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NPI Code Detail

MEDICARE: QC NURSING, LLC

MEDICARE: QC NURSING, 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
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1841547965
Entity Type Code : Organization
Provider Name (Legal Business Name) : QC NURSING, LLC
Provider Business Mailing Address
First Line : 13500 BRANDON PL
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-4312
Country : US
Telephone Number : 405-720-0010
Fax Number : 405-720-1397
Provider Business Practice Location Address
First Line : 13500 BRANDON PL
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-4312
Country : US
Telephone Number : 405-720-0010
Fax Number : 405-720-1397
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BOYD P GENTRY
Credential :
Telephone Number : 678-869-5118
Provider Enumeration Date : 08/08/2012
Last Update Date : 08/08/2012

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