Provider Demographics
NPI:1306027313
Name:QUALITY ASSURED HEALTHCARE PROVIDERS
Entity Type:Organization
Organization Name:QUALITY ASSURED HEALTHCARE PROVIDERS
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOLULOPE
Authorized Official - Middle Name:SUNDAY
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-787-0999
Mailing Address - Street 1:1404 CRAIN HWY S
Mailing Address - Street 2:206
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4085
Mailing Address - Country:US
Mailing Address - Phone:410-787-0999
Mailing Address - Fax:
Practice Address - Street 1:1404 CRAIN HWY S
Practice Address - Street 2:206
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4085
Practice Address - Country:US
Practice Address - Phone:410-787-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2464 (RSA LICENSE)251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health