Organization
QC-MEDI NEW YORK, INC.
Active
Other names
CenterWell Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN NICHOLS (AUTHORIZED SIGNATORY)
(631) 232-6030
Entity
Organization
Contact information
Practice address
1393 VETERANS MEMORIAL HWY STE 204S, HAUPPAUGE, NY 11788-3069
(631) 232-6030
Mailing address
6330 SPRINT PKWY STE 300, OVERLAND PARK, KS 66211-1157
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400510009
1B
—
01
—
004564
G2
—
05
—
01047281
—
NY
01
—
040401001283
G2
—
01
—
112256479
G2
—
01
—
112645333
G2
—
01
—
116529
G2
—
01
—
1166983
G2
—
01
—
145040
G2
—
01
—
19001
G2
—
01
—
202035308
G2
—
01
—
227654
G2
—
01
—
337224
G2
—
01
—
337232
G2
—
01
—
565800
G2
—
01
—
6002016
G2
—
01
—
7695046
G2
—
01
—
866452
G2
—
01
—
94693
G2
—
Enumeration date
07/06/2006
Last updated
09/26/2024
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