Provider Demographics
NPI:1578740148
Name:QUALITY LIFE BIRTH RESOURCES
Entity Type:Organization
Organization Name:QUALITY LIFE BIRTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:FILENE
Authorized Official - Last Name:SPEERS-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:612-522-7792
Mailing Address - Street 1:2708 IRVING AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1227
Mailing Address - Country:US
Mailing Address - Phone:612-522-7792
Mailing Address - Fax:612-588-9945
Practice Address - Street 1:2708 IRVING AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1227
Practice Address - Country:US
Practice Address - Phone:612-522-7792
Practice Address - Fax:612-588-9945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment