Organization
QUALITY OF LIFE DME LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY P LOCKETT DO (OWNER)
(727) 896-8686
Entity
Organization
Contact information
Practice address
1501 5TH AVE N, ST PETERSBURG, FL 33705-2008
(727) 485-8780
(855) 816-9860
Mailing address
1501 5TH AVE N, ST PETERSBURG, FL 33705-2008
(727) 485-8780
(855) 816-9860
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
OS6109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
56170300
—
FL
Enumeration date
12/18/2017
Last updated
06/16/2018
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