Provider Demographics
NPI:1982611042
Name:QUICKSTAR HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:QUICKSTAR HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAYYAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-968-1763
Mailing Address - Street 1:21700 GREENFIELD RD
Mailing Address - Street 2:SUITE 238A
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237
Mailing Address - Country:US
Mailing Address - Phone:248-968-1763
Mailing Address - Fax:248-968-1779
Practice Address - Street 1:21700 GREENFIELD RD
Practice Address - Street 2:SUITE 238A
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237
Practice Address - Country:US
Practice Address - Phone:248-968-1763
Practice Address - Fax:248-968-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5217780001Medicare ID - Type Unspecified