Provider Demographics
NPI:1134659139
Name:QUALITY CARE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:QUALITY CARE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-598-4078
Mailing Address - Street 1:126 BLAKE RD N STE 1
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8201
Mailing Address - Country:US
Mailing Address - Phone:612-598-4078
Mailing Address - Fax:
Practice Address - Street 1:126 BLAKE RD N
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8201
Practice Address - Country:US
Practice Address - Phone:612-598-4078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies