Provider Demographics
NPI:1497081988
Name:QUALITY FIRST MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:QUALITY FIRST MEDICAL SUPPLIES LLC
Other - Org Name:QUALITY FIRST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-585-3045
Mailing Address - Street 1:115 W 3RD ST
Mailing Address - Street 2:SUITE 820
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-3410
Mailing Address - Country:US
Mailing Address - Phone:918-585-3045
Mailing Address - Fax:918-585-3047
Practice Address - Street 1:115 W 3RD ST STE 820
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3410
Practice Address - Country:US
Practice Address - Phone:918-585-3069
Practice Address - Fax:918-574-8569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336C0003X, 3336C0004X, 3336H0001X, 3336I0012X, 3336S0011X
OK254283336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200272180AMedicaid
3725946OtherNCPDP PROVIDER IDENTIFICATION NUMBER
6377820001Medicare NSC