Provider Demographics
NPI:1164426003
Name:QUALITY MEDICAL CARE AND SERVICES, L.L.C.
Entity Type:Organization
Organization Name:QUALITY MEDICAL CARE AND SERVICES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:ASWELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:337-363-7474
Mailing Address - Street 1:903 TATE COVE RD
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-3600
Mailing Address - Country:US
Mailing Address - Phone:337-363-8101
Mailing Address - Fax:337-363-8656
Practice Address - Street 1:903 TATE COVE RD
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-3600
Practice Address - Country:US
Practice Address - Phone:337-363-8101
Practice Address - Fax:337-363-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1463051Medicaid
LA1463051Medicaid