Provider Demographics
NPI:1447829379
Name:QUICK CARE MED, LLC
Entity type:Organization
Organization Name:QUICK CARE MED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRED SPEC
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-634-8736
Mailing Address - Street 1:PO BOX 2066
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34460-2066
Mailing Address - Country:US
Mailing Address - Phone:352-563-0931
Mailing Address - Fax:352-563-0935
Practice Address - Street 1:2205 N YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-1957
Practice Address - Country:US
Practice Address - Phone:352-535-2273
Practice Address - Fax:352-614-4059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUICK CARE MED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-24
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003672418Medicaid