Provider Demographics
NPI:1831556489
Name:QWEST HOME HEALTH CARE AGENCY
Entity type:Organization
Organization Name:QWEST HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-879-8700
Mailing Address - Street 1:144 BUSINESS PARK DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6527
Mailing Address - Country:US
Mailing Address - Phone:757-499-5060
Mailing Address - Fax:
Practice Address - Street 1:144 BUSINESS PARK DR
Practice Address - Street 2:SUITE 105
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6527
Practice Address - Country:US
Practice Address - Phone:757-499-5060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO- 161379251J00000X
VAHCO-161379251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care