Provider Demographics
NPI:1720209539
Name:QUALITY CHOICE MEDICAL EQUIPMENT AND SUPPLY
Entity Type:Organization
Organization Name:QUALITY CHOICE MEDICAL EQUIPMENT AND SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RESURRECTION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-623-8244
Mailing Address - Street 1:2026 CONNECTICUT AVE
Mailing Address - Street 2:STE A
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1107
Mailing Address - Country:US
Mailing Address - Phone:417-623-8244
Mailing Address - Fax:
Practice Address - Street 1:2026 CONNECTICUT AVE
Practice Address - Street 2:STE A
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-1107
Practice Address - Country:US
Practice Address - Phone:417-623-8244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4046900001Medicare ID - Type Unspecified