Provider Demographics
NPI:1669616728
Name:QUALITY CARE MEDICAL SUPPLY
Entity type:Organization
Organization Name:QUALITY CARE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EVANS
Authorized Official - Middle Name:O
Authorized Official - Last Name:ALAWURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-701-5143
Mailing Address - Street 1:11551 237TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-3924
Mailing Address - Country:US
Mailing Address - Phone:191-770-1514
Mailing Address - Fax:516-612-2542
Practice Address - Street 1:11551 237TH ST
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3924
Practice Address - Country:US
Practice Address - Phone:191-770-1514
Practice Address - Fax:516-612-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1420716332BX2000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1420716OtherNEW YORK CITY