Provider Demographics
NPI:1104363035
Name:QUADMED MANAGEMENT, LLC
Entity Type:Organization
Organization Name:QUADMED MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRATITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURANT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:844-708-4822
Mailing Address - Street 1:N53W24700 S CORPORATE CIR
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-4359
Mailing Address - Country:US
Mailing Address - Phone:317-791-6691
Mailing Address - Fax:317-791-6680
Practice Address - Street 1:1701 TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3008
Practice Address - Country:US
Practice Address - Phone:844-708-4822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUAD/GRAPHICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149803261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care