Provider Demographics
NPI:1417305798
Name:QUADRICISER CORPORATION
Entity Type:Organization
Organization Name:QUADRICISER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-689-5003
Mailing Address - Street 1:6624 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1400
Mailing Address - Country:US
Mailing Address - Phone:865-689-5003
Mailing Address - Fax:
Practice Address - Street 1:6624 CENTRAL AVENUE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-1400
Practice Address - Country:US
Practice Address - Phone:865-689-5003
Practice Address - Fax:865-689-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TN0317777332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1417305798OtherNPI