Provider Demographics
NPI:1275601445
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 1:243 GORDAN ROAD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-1502
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:2006-12-04
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC31223747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601342Medicaid
NC3418041OtherCAP