Provider Demographics
NPI:1518400910
Name:QI DATA SYSTEMS, INC.
Entity Type:Organization
Organization Name:QI DATA SYSTEMS, INC.
Other - Org Name:MOBILE LIFE SUPPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:415-902-4991
Mailing Address - Street 1:PO BOX 1003
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90801-1003
Mailing Address - Country:US
Mailing Address - Phone:415-902-4991
Mailing Address - Fax:
Practice Address - Street 1:150 THE PROMENADE N UNIT 511
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4756
Practice Address - Country:US
Practice Address - Phone:415-902-4991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport