QUALITY OF LIFE HEALTH SERVICES, INC (CLAY QUALITY HEALTH CARE) - NPI NUMBER 1598187783

Summary

Provider Name: QUALITY OF LIFE HEALTH SERVICES, INC (CLAY QUALITY HEALTH CARE)

NPI Number: 1598187783

Clasification: Clinic/Center (261QF0400X)

Specialization: Federally Qualified Health Center (FQHC)

Address:
40745 HIGHWAY 77
ASHLAND, AL
ZIP 36251

Phone Number: (256) 492-0131



Detailed Information

QUALITY OF LIFE HEALTH SERVICES, INC is a federally qualified health center (fqhc) clinic/center in Ashland, AL. The assigned NPI number for this provider is 1598187783 and is registered as an organization entity type.
The provider Is Doing Business As Clay Quality Health Care.

The provider's business address is:

40745 HIGHWAY 77
ASHLAND, AL
ZIP 36251-807
Phone: (256) 492-0131

The provider's authorized official is Wayne Rowe .
The authorized official title is Ceo and has the following contact phone number (256) 492-0131.

The enumeration date for this NPI number is 1/8/2014 and was last updated on 1/8/2014.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1467855445 CLAY COUNTY HEALTHCARE AUTHORITY
Clinic/Center (Primary Care)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1598187783 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name QUALITY OF LIFE HEALTH SERVICES, INC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name CLAY QUALITY HEALTH CARE Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 40745 HIGHWAY 77 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name ASHLAND The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name AL The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 362514807 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 2564920131 The telephone number associated with the location address of the provider being identified.
13 Provider Enumeration Date 1/8/2014 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 1/8/2014 The date that a record was last updated or changed.
15 Authorized Official Last Name ROWE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name WAYNE The first name of the authorized official.
17 Authorized Official Title or Position CEO The title or position of the authorized official.
18 Authorized Official Telephone Number 2564920131 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 261QF0400X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Credential Text MPA

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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