Provider Demographics
NPI:1700218864
Name:PQA HEALTHCARE, INC
Entity Type:Organization
Organization Name:PQA HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:336-356-2600
Mailing Address - Street 1:300 NORTHGATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3482
Mailing Address - Country:US
Mailing Address - Phone:336-306-9690
Mailing Address - Fax:336-306-9696
Practice Address - Street 1:300 NORTHGATE PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3482
Practice Address - Country:US
Practice Address - Phone:336-306-9690
Practice Address - Fax:336-306-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health