Provider Demographics
NPI:1811396914
Name:QMI LLC
Entity Type:Organization
Organization Name:QMI LLC
Other - Org Name:MILAN U SAVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-265-3779
Mailing Address - Street 1:111 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:MO
Mailing Address - Zip Code:63556-1331
Mailing Address - Country:US
Mailing Address - Phone:660-265-3779
Mailing Address - Fax:660-265-3966
Practice Address - Street 1:111 E 2ND ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MO
Practice Address - Zip Code:63556-1331
Practice Address - Country:US
Practice Address - Phone:660-265-3779
Practice Address - Fax:660-265-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140278363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147581OtherPK