MEDICARE: QUALITY MEDICAL SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1831590587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY MEDICAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4757 E GREENWAY RD
Second Line	:	STE 107B-193
City	:	PHOENIX
State	:	AZ
Zip	:	85032-8513
Country	:	US
Telephone Number	:	559-696-6927
Fax Number	:	602-992-0629

Provider Business Practice Location Address
First Line	:	4757 E GREENWAY RD
Second Line	:	STE 107B-193
City	:	PHOENIX
State	:	AZ
Zip	:	85032-8513
Country	:	US
Telephone Number	:	559-696-6927
Fax Number	:	602-992-0629

Authorized Official
Title or Position	:	CEO
Name	:	SCOTT FRANKLIN OSTROW
Credential	:
Telephone Number	:	559-696-6927

Provider Enumeration Date	:	09/12/2014
Last Update Date	:	09/12/2014

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