Provider Demographics
NPI:1083602577
Name:QUALITY HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:QUALITY HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:HART
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-319-2277
Mailing Address - Street 1:11535 CARMEL COMMONS BLVD
Mailing Address - Street 2:105
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5313
Mailing Address - Country:US
Mailing Address - Phone:704-319-2277
Mailing Address - Fax:704-319-2278
Practice Address - Street 1:11535 CARMEL COMMONS BLVD
Practice Address - Street 2:105
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5313
Practice Address - Country:US
Practice Address - Phone:704-319-2277
Practice Address - Fax:704-319-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1464163W00000X, 164W00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Not Answered376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600499Medicaid
NC3408850Medicaid
NC7100281Medicaid