Provider Demographics
NPI:1225133671
Name:QUALITY HOME MEDICAL INC.
Entity Type:Organization
Organization Name:QUALITY HOME MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-599-9945
Mailing Address - Street 1:130 ROGERS COMMERCE BLVD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-6144
Mailing Address - Country:US
Mailing Address - Phone:864-599-9945
Mailing Address - Fax:
Practice Address - Street 1:247 OAK ST
Practice Address - Street 2:SUITE 111
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3539
Practice Address - Country:US
Practice Address - Phone:828-288-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703335Medicaid
NC7703335Medicaid