Provider Demographics
NPI:1629089578
Name:QUAKER STATE MEDICAL SERVICES CO INC
Entity Type:Organization
Organization Name:QUAKER STATE MEDICAL SERVICES CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:POLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-458-9250
Mailing Address - Street 1:760 CONSTITUTION DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1149
Mailing Address - Country:US
Mailing Address - Phone:610-458-9250
Mailing Address - Fax:610-458-9207
Practice Address - Street 1:760 CONSTITUTION DR
Practice Address - Street 2:SUITE 20
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1149
Practice Address - Country:US
Practice Address - Phone:610-458-9250
Practice Address - Fax:610-458-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
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