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General NPI Number Information
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NPI Number | 1215206263
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Entity Type | Organization
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Legal Business Name | QMP PHARMACY LLC
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 102 W MAIN ST SUITE B
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City | WARSAW
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State | KY
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Zip | 41095-9300
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Country | US
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Telephone | 800-767-0874
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Fax | 888-716-6567
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Provider Business Mailing Address
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Address Line | 5180 W ATLANTIC AVE SUITE 105
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8103
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Country | US
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Telephone | 800-767-0874
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Fax | 888-716-6567
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | JORDAN C SOBLICK
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Credential |
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Telephone | 800-767-0874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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