Provider Demographics
NPI:1033295779
Name:QUALITY LIFE PRODUCTS, LLC
Entity Type:Organization
Organization Name:QUALITY LIFE PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FREVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-377-0608
Mailing Address - Street 1:1415 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-2036
Mailing Address - Country:US
Mailing Address - Phone:319-377-0608
Mailing Address - Fax:319-377-1017
Practice Address - Street 1:1415 24TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-2036
Practice Address - Country:US
Practice Address - Phone:319-377-0608
Practice Address - Fax:319-377-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0445197Medicaid
IA0445197Medicaid