Provider Demographics
NPI:1467638163
Name:QRS LLC
Entity Type:Organization
Organization Name:QRS LLC
Other - Org Name:CORNERSTONE DIAGNOSTIC SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:SCHIDER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:941-624-0131
Mailing Address - Street 1:17218 TOLEDO BLADE BLVD.
Mailing Address - Street 2:UNIT 7
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954
Mailing Address - Country:US
Mailing Address - Phone:941-624-0131
Mailing Address - Fax:
Practice Address - Street 1:17218 TOLEDO BLADE BLVD.
Practice Address - Street 2:UNIT 7
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954
Practice Address - Country:US
Practice Address - Phone:941-624-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8115261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
V3332OtherBLUE CROSS BLUE SHIELD