Provider Demographics
NPI:1902404452
Name:SCARBERRY, QUENTIN
Entity Type:Individual
Prefix:
First Name:QUENTIN
Middle Name:
Last Name:SCARBERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22983 BIG PINE RD
Mailing Address - Street 2:
Mailing Address - City:LAURELVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43135-9752
Mailing Address - Country:US
Mailing Address - Phone:740-279-8525
Mailing Address - Fax:
Practice Address - Street 1:22983 BIG PINE RD
Practice Address - Street 2:
Practice Address - City:LAURELVILLE
Practice Address - State:OH
Practice Address - Zip Code:43135-9752
Practice Address - Country:US
Practice Address - Phone:740-279-8525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker