=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235169988
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | Q-MED CONCEPTS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/04/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2551 WESTBELT DR
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43228-3826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-777-1505
-----------------------------------------------------
Fax | 614-777-1506
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2551 WESTBELT DR
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43228-3826
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-777-1505
-----------------------------------------------------
Fax | 614-777-1506
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | C.O.O.
-----------------------------------------------------
Name | MR. DAVID S MAXWELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-777-1505
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BP3500X
-----------------------------------------------------
Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------