Provider Demographics
NPI:1770160632
Name:QUANTUMHEALTH LLC
Entity type:Organization
Organization Name:QUANTUMHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN SMITH
Authorized Official - Last Name:LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-439-1190
Mailing Address - Street 1:1281 E ALLUVIAL AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2688
Mailing Address - Country:US
Mailing Address - Phone:559-439-1190
Mailing Address - Fax:559-439-1655
Practice Address - Street 1:1281 E ALLUVIAL AVE
Practice Address - Street 2:STE 116
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2688
Practice Address - Country:US
Practice Address - Phone:559-439-1190
Practice Address - Fax:559-439-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy