Healthcare Provider Details
I. General information
NPI: 1750388682
Provider Name (Legal Business Name): QUALITY HOME MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 ROGERS COMMERCE BLVD
BOILING SPRINGS SC
29316-6144
US
IV. Provider business mailing address
555 E NORTH LN STE 5075
CONSHOHOCKEN PA
19428-2490
US
V. Phone/Fax
- Phone: 864-599-9945
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | 042418419 |
| License Number State | SC |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
WENDY
RUSSALESI
Title or Position: CCO
Credential:
Phone: 484-246-9499