Provider Demographics
NPI:1033213061
Name:QUALITY IN HOME CARE AGENCY, INC.
Entity Type:Organization
Organization Name:QUALITY IN HOME CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRIS
Authorized Official - Middle Name:CORNELIUS
Authorized Official - Last Name:MCPHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-299-0099
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28329-0041
Mailing Address - Country:US
Mailing Address - Phone:910-299-0099
Mailing Address - Fax:910-299-0010
Practice Address - Street 1:334 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4226
Practice Address - Country:US
Practice Address - Phone:910-299-0099
Practice Address - Fax:910-299-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704462Medicaid
NC5607930001Medicare NSC