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General NPI Number Information
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NPI Number | 1366875403
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Entity Type | Organization
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Legal Business Name | QUALITY OF LIFE HEALTH SERVICES INC
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 707 W MARTIN LUTHER KING HWY
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City | TUSKEGEE
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State | AL
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Zip | 36083-2138
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Country | US
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Telephone | 334-727-7341
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Fax | 334-727-7241
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Provider Business Mailing Address
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Address Line | PO BOX 97
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City | GADSDEN
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State | AL
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Zip | 35902-0097
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Country | US
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Telephone | 256-393-4063
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Fax | 256-543-0340
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Authorized Official
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Title or Position | CEO
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Name | WAYNE ROWE
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Credential |
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Telephone | 256-492-0131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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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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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 114180
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License Number State | AL
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