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General NPI Number Information
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NPI Number | 1033577168
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Entity Type | Organization
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Legal Business Name | QUMAR HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 445 DEXTER AVE SUITE 4050
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City | MONTGOMERY
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State | AL
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Zip | 36104-3775
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Country | US
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Telephone | 334-557-7021
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Fax |
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Provider Business Mailing Address
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Address Line | 445 DEXTER AVE SUITE 4050
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City | MONTGOMERY
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State | AL
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Zip | 36104-3775
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Country | US
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Telephone | 334-557-7021
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Fax |
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Authorized Official
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Title or Position | OWNER AND CEO/PHLEBOTOMY TECHNICIAN
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Name | MARCY E ANDERSON
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Credential |
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Telephone | 317-938-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 5000-663
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License Number State | AL
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