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General NPI Number Information
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NPI Number | 1982964292
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Entity Type | Organization
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Legal Business Name | QUALITY ADVANTAGE HOME PRODUCTS, INC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 610 N ARMISTEAD AVE
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City | HAMPTON
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State | VA
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Zip | 23669-3047
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Country | US
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Telephone | 757-728-3755
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Fax | 757-728-3735
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Provider Business Mailing Address
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Address Line | 610 N ARMISTEAD AVE
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City | HAMPTON
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State | VA
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Zip | 23669-3047
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Country | US
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Telephone | 757-728-3755
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Fax | 757-728-3735
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Authorized Official
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Title or Position | VICE PRESIDENT/GENERAL MANAGER
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Name | CHRISTOPHER BENTON SHENK
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Credential |
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Telephone | 757-728-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 2705 040492A
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License Number State | VA
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