Provider Demographics
NPI:1609293331
Name:QUALITY MINERS HEALTHCARE LLC
Entity Type:Organization
Organization Name:QUALITY MINERS HEALTHCARE LLC
Other - Org Name:QUALITY MINERS HEALTHCARE AND MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:505-285-9861
Mailing Address - Street 1:PO BOX 1718
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-1718
Mailing Address - Country:US
Mailing Address - Phone:505-285-9861
Mailing Address - Fax:888-972-4314
Practice Address - Street 1:409 N FIRST ST
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2544
Practice Address - Country:US
Practice Address - Phone:505-285-9861
Practice Address - Fax:888-972-4314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3461251E00000X
332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies