Healthcare Provider Details

I. General information

NPI: 1558632216
Provider Name (Legal Business Name): QUALITY OF LIFE HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 WESLEY ST STE 3
JOHNSON CITY TN
37601-1741
US

IV. Provider business mailing address

302 WESLEY ST STE 3
JOHNSON CITY TN
37601-1741
US

V. Phone/Fax

Practice location:
  • Phone: 423-202-3772
  • Fax: 423-202-3445
Mailing address:
  • Phone: 423-202-3772
  • Fax: 423-202-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES FAMOYIN
Title or Position: PRESIDENT
Credential: MD
Phone: 423-431-8889