Provider Demographics
NPI:1366191587
Name:QUALITYCARE MEDICAL CONCIERGE, LLC
Entity type:Organization
Organization Name:QUALITYCARE MEDICAL CONCIERGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:RACHAEL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:AHI, CPT
Authorized Official - Phone:912-631-6448
Mailing Address - Street 1:#1018
Mailing Address - Street 2:1915 E. VICTORY DRIVE SUITE E
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404
Mailing Address - Country:US
Mailing Address - Phone:912-662-6319
Mailing Address - Fax:
Practice Address - Street 1:1402 CATHY ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31415-7805
Practice Address - Country:US
Practice Address - Phone:912-631-6448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No291U00000XLaboratoriesClinical Medical Laboratory
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care