Provider Demographics
NPI:1215206263
Name:QMP PHARMACY LLC
Entity Type:Organization
Organization Name:QMP PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOBLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-767-0874
Mailing Address - Street 1:5180 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8103
Mailing Address - Country:US
Mailing Address - Phone:800-767-0874
Mailing Address - Fax:888-716-6567
Practice Address - Street 1:102 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WARSAW
Practice Address - State:KY
Practice Address - Zip Code:41095-9300
Practice Address - Country:US
Practice Address - Phone:800-767-0874
Practice Address - Fax:888-716-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies