Provider Demographics
NPI:1487671491
Name:QUALITY MEDICAL SUPPLY OF NASHVILLE, INC.
Entity Type:Organization
Organization Name:QUALITY MEDICAL SUPPLY OF NASHVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-255-4665
Mailing Address - Street 1:217 BLANTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-4703
Mailing Address - Country:US
Mailing Address - Phone:615-255-4665
Mailing Address - Fax:615-259-9556
Practice Address - Street 1:217 BLANTON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-4703
Practice Address - Country:US
Practice Address - Phone:615-255-4665
Practice Address - Fax:615-259-9556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000481332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3553596Medicaid
TN0133920001Medicare NSC