Provider Demographics
NPI:1558632216
Name:QUALITY OF LIFE HEALTHCARE INC.
Entity Type:Organization
Organization Name:QUALITY OF LIFE HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FAMOYIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-431-8889
Mailing Address - Street 1:302 WESLEY ST STE 3
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1741
Mailing Address - Country:US
Mailing Address - Phone:423-282-0561
Mailing Address - Fax:423-282-0563
Practice Address - Street 1:302 WESLEY ST STE 3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1741
Practice Address - Country:US
Practice Address - Phone:423-282-0561
Practice Address - Fax:423-282-0563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty