Provider Demographics
NPI:1407041130
Name:QUALITY SUPPLY LLC
Entity type:Organization
Organization Name:QUALITY SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DME CLINICAL COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:270-929-3281
Mailing Address - Street 1:1126 TRIPLETT ST
Mailing Address - Street 2:SUITE #103
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-3155
Mailing Address - Country:US
Mailing Address - Phone:270-852-4343
Mailing Address - Fax:270-852-4344
Practice Address - Street 1:1126 TRIPLETT ST
Practice Address - Street 2:SUITE #103
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3155
Practice Address - Country:US
Practice Address - Phone:270-852-4343
Practice Address - Fax:270-852-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6063720001Medicare NSC