NPIMap

Organization Active NPI

Quilted Care LTD. Co, Dba Peppertree Square

  • Health Service Clinic/Center
  • Peoria, AZ
National Provider Identifier
1689885543
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
ALC-4673 Issued in AZ
Legal business name
QUILTED CARE LTD. CO, DBA PEPPERTREE SQUARE
Practice address
10420 N 89TH Ave
Peoria, AZ 85345-6453
Phone
(623) 878-5115
Fax
(623) 878-1604
NPI assigned
May 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Etta Koskovich
Title
Administrator
Phone
(623) 878-5115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X ALC-4673 AZ Primary

Addresses

Primary practice location

10420 N 89TH Ave
Peoria, AZ 85345-6453

Mailing address

10420 N 89TH Ave
Peoria, AZ 85345-6453

National Provider Directory

National Provider Directory
Tax ID family
Quilted Care LTD Co4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689885543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 N 89TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 N 89TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853456453",
            "telephone_number": "623-878-5115",
            "fax_number": "623-878-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUILTED CARE LTD. CO, DBA PEPPERTREE SQUARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSKOVICH",
        "authorized_official_first_name": "ETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-878-5115"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": "ALC-4673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.