Healthcare Provider Details

I. General information

NPI: 1376991695
Provider Name (Legal Business Name): QUALITY MEDRX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E MICHIGAN AVE
LANSING MI
48912-2894
US

IV. Provider business mailing address

1601 E MICHIGAN AVE
LANSING MI
48912-2894
US

V. Phone/Fax

Practice location:
  • Phone: 888-578-3044
  • Fax: 517-485-4789
Mailing address:
  • Phone: 888-578-3044
  • Fax: 517-485-4789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301010956
License Number StateMI

VIII. Authorized Official

Name: JON SANFORD
Title or Position: PRESIDENT/AO
Credential:
Phone: 517-899-1680