Provider Demographics
NPI:1679687644
Name:QUESTCARE PHCY LLC
Entity type:Organization
Organization Name:QUESTCARE PHCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/VP
Authorized Official - Prefix:
Authorized Official - First Name:SASQUIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIELES MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-747-9122
Mailing Address - Street 1:5600 NW 102ND AVE STE M-4
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8709
Mailing Address - Country:US
Mailing Address - Phone:954-747-9122
Mailing Address - Fax:954-747-9125
Practice Address - Street 1:5600 NW 102ND AVE STE M-4
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8709
Practice Address - Country:US
Practice Address - Phone:954-747-9122
Practice Address - Fax:954-747-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH178943336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1092915OtherNCPDP PROVIDER IDENTIFICATION NUMBER