QLS Fairmont LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

QLS FAIRMONT LLC

Doing business as

Quality Life Services - Fairmont

Practice address

130 Kaufman Dr
Fairmont, WV 26554-2179

Phone

(724) 431-0700

NPI assigned

Dec 27, 2017

Last updated

Dec 27, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

TACK HUD LEASE HOLDINGS LPAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dean Rippee

Title

Cfo

Phone

(724) 431-0770

Specialties & licenses 1

Addresses

Other names 1

• Quality Life Services - Fairmont Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1629584727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N MAIN ST",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160014363",
            "telephone_number": "724-431-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 KAUFMAN DR",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542179",
            "telephone_number": "724-431-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QLS FAIRMONT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TACK HUD LEASE HOLDINGS LP",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "RIPPEE",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "724-431-0770"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Life Services - Fairmont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Profitt
• Diane Carol Prunty
• Amanda Puleo, DO
• Jamie Pulice
• Georgetta Louise Pyles
• Quality Case Management Solutions
• Sherry Quinn
• Kimberly Quirk
• R & N Health Care Supplies
• Justin Cameron Rabideau

• Skilled Nursing Facility in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.