Provider Demographics
NPI:1396829800
Name:QUALITY HOME HEALTH CARE OF THE GULF COAST, INC.
Entity Type:Organization
Organization Name:QUALITY HOME HEALTH CARE OF THE GULF COAST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-374-2273
Mailing Address - Street 1:1001 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-3745
Mailing Address - Country:US
Mailing Address - Phone:228-374-2273
Mailing Address - Fax:228-374-6673
Practice Address - Street 1:1001 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-3745
Practice Address - Country:US
Practice Address - Phone:228-374-2273
Practice Address - Fax:228-374-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9681251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770071Medicaid
MS257111Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER