Provider Demographics
NPI:1003205691
Name:QUICKSTART HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:QUICKSTART HEALTH SERVICES LLC
Other - Org Name:QUICKSTART HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAYEMI
Authorized Official - Middle Name:OLAJUMOKE
Authorized Official - Last Name:KILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-623-2446
Mailing Address - Street 1:9812 DEE WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1754
Mailing Address - Country:US
Mailing Address - Phone:443-438-8743
Mailing Address - Fax:410-574-9797
Practice Address - Street 1:9812 DEE WAY
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-1754
Practice Address - Country:US
Practice Address - Phone:443-438-8743
Practice Address - Fax:410-574-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3693251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health