Provider Demographics
NPI:1760264360
Name:QUANTUM HEALTH
Entity Type:Organization
Organization Name:QUANTUM HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RA
Authorized Official - Prefix:
Authorized Official - First Name:JESICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-575-1069
Mailing Address - Street 1:15000 POTOMAC TOWN PL STE 100
Mailing Address - Street 2:PMB 148
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:571-575-1069
Mailing Address - Fax:
Practice Address - Street 1:200 MORTON RD
Practice Address - Street 2:
Practice Address - City:FREDERKSBERG
Practice Address - State:VA
Practice Address - Zip Code:22405
Practice Address - Country:US
Practice Address - Phone:571-575-1069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health