Provider Demographics
NPI:1922348820
Name:QUARSHIE, PHILOMENA K
Entity Type:Individual
Prefix:MS
First Name:PHILOMENA
Middle Name:K
Last Name:QUARSHIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PROFESSIONAL
Other - Middle Name:QUALITY
Other - Last Name:HOME CARE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1180 MCKENDREE CHURCH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-5207
Mailing Address - Country:US
Mailing Address - Phone:770-892-6820
Mailing Address - Fax:
Practice Address - Street 1:1180 MCKENDREE CHURCH RD STE 201
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5207
Practice Address - Country:US
Practice Address - Phone:770-892-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHCP010778374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA844905826Medicaid
844905826Other000000