Organization
QUALITY HOME MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES FULLER (VICE PRESIDENT OF OPERATIONS)
(864) 599-9945
Entity
Organization
Contact information
Practice address
362 N PINE ST, SPARTANBURG, SC 29302
(864) 599-9945
(864) 599-7713
Mailing address
130 ROGERS COMMERCE BLVD, BOILING SPRINGS, SC 29316-6144
(864) 599-9945
(864) 599-7713
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
042543382
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1178540004
MEDICARE PTAN
SC
05
—
DE1135
—
SC
Enumeration date
11/15/2012
Last updated
07/10/2014
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