Provider Demographics
NPI:1952437972
Name:PQA HEALTHCARE, INC.
Entity Type:Organization
Organization Name:PQA HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR, QP
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:SAID
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-356-2600
Mailing Address - Street 1:701 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-0701
Mailing Address - Country:US
Mailing Address - Phone:336-356-2600
Mailing Address - Fax:336-356-2601
Practice Address - Street 1:701 MAIN ST S
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-0701
Practice Address - Country:US
Practice Address - Phone:336-356-2600
Practice Address - Fax:336-356-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409424Medicaid
NC8300631Medicaid
NC8300631BMedicaid
NC8300631GMedicaid