Basic Information
Provider Information
NPI: 1821321274
EntityType: 2
ReplacementNPI:  
OrganizationName: QUALITY PLUS MEDICAL SERVICES, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2245 MARTIN ST S
Address2:  
City: PELL CITY
State: AL
PostalCode: 351282309
CountryCode: US
TelephoneNumber: 2059885520
FaxNumber: 2059897986
Practice Location
Address1: 2245 MARTIN ST S
Address2:  
City: PELL CITY
State: AL
PostalCode: 351282309
CountryCode: US
TelephoneNumber: 2059885520
FaxNumber: 2059897986
Other Information
ProviderEnumerationDate: 09/16/2009
LastUpdateDate: 09/16/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HODGES
AuthorizedOfficialFirstName: GLORIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VICE PRESIDENT/OWNER
AuthorizedOfficialTelephone: 2059885520
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: QUALITY PLUS MEDICAL SERVICES, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

ID Information
IDTypeStateIssuerDescription
00005713805AL MEDICAID
5713801ALBLUE CROSS OF ALABAMAOTHER


Home