Provider Demographics
NPI:1275844045
Name:QUALITY CARE MEDICAL CENTER PC
Entity Type:Organization
Organization Name:QUALITY CARE MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ZAMMAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-942-9494
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16603-1111
Mailing Address - Country:US
Mailing Address - Phone:814-942-9494
Mailing Address - Fax:814-942-4403
Practice Address - Street 1:2950 FAIRWAY DR
Practice Address - Street 2:SUITE # 2
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4494
Practice Address - Country:US
Practice Address - Phone:814-942-9494
Practice Address - Fax:814-942-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-27
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024847480001Medicaid