Healthcare Provider Details

I. General information

NPI: 1386036713
Provider Name (Legal Business Name): QUALITY ZONE PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 02/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BELMONT AVE
SPRINGFIELD MA
01108-2000
US

IV. Provider business mailing address

355 BELMONT AVE
SPRINGFIELD MA
01108-2000
US

V. Phone/Fax

Practice location:
  • Phone: 413-739-3900
  • Fax: 413-739-3909
Mailing address:
  • Phone: 413-739-3900
  • Fax: 413-739-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberDS89954
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SAMIR DESAI
Title or Position: PRESIDENT
Credential:
Phone: 413-739-3900