Healthcare Provider Details

I. General information

NPI: 1649695362
Provider Name (Legal Business Name): QUALITY OF LIFE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 GILES ST
HEFLIN AL
36264-1738
US

IV. Provider business mailing address

1411 PIEDMONT CUTOFF OFC
GADSDEN AL
35903-2708
US

V. Phone/Fax

Practice location:
  • Phone: 256-463-3307
  • Fax: 256-463-2024
Mailing address:
  • Phone: 256-439-6402
  • Fax: 256-543-0340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number114295
License Number StateAL

VIII. Authorized Official

Name: WAYNE ROWE
Title or Position: CEO
Credential:
Phone: 256-492-0131