Provider Demographics
NPI:1154948024
Name:QUALITY MEDICAL SPECIALISTS LLC
Entity type:Organization
Organization Name:QUALITY MEDICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROY MARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARGALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:725-500-8048
Mailing Address - Street 1:10725 PRAIRIE WHEAT CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-8688
Mailing Address - Country:US
Mailing Address - Phone:725-500-8048
Mailing Address - Fax:
Practice Address - Street 1:10725 PRAIRIE WHEAT CT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-8688
Practice Address - Country:US
Practice Address - Phone:725-500-8048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty