Provider Demographics
NPI:1144106105
Name:QUICK CARE DIAGNOSTIC LLC
Entity type:Organization
Organization Name:QUICK CARE DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCPHERSONS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:786-704-0246
Mailing Address - Street 1:14030 KORNBLUM AVE APT 117
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8664
Mailing Address - Country:US
Mailing Address - Phone:786-704-0246
Mailing Address - Fax:
Practice Address - Street 1:14030 KORNBLUM AVE APT 117
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-8664
Practice Address - Country:US
Practice Address - Phone:786-704-0246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies