1184854002 NPI number — QUALITY SOUTH, INC.

Table of content: (NPI 1184854002)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184854002 NPI number — QUALITY SOUTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY SOUTH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184854002
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6001 N ADAMS RD STE 165
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
BLOOMFIELD HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48304-1547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-641-7200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7000 BROCKPORT CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTGOMERY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36117-8019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-322-8897
Provider Business Practice Location Address Fax Number:
334-224-1166
Provider Enumeration Date:
07/27/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARKER
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
Authorized Official Title or Position:
C.O.O.
Authorized Official Telephone Number:
248-641-7200

Provider Taxonomy Codes

  • Taxonomy code: 320600000X , with the licence number:  012465 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)