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Organization
LIFESOURCE TECHNOLOGIES INC.
Active
Organization
LIFESOURCE TECHNOLOGIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONZELLA LYNNE FLETCHER (OWNER)
(951) 736-6160
Entity
Organization
Contact information
Practice address
1307 W 6TH ST, SUITE 207, CORONA, CA 92882-3294
(951) 736-6160
(951) 736-0440
Mailing address
1307 W 6TH ST, SUITE 207, CORONA, CA 92882-3294
(951) 736-6160
(951) 736-0440
Taxonomy
Speciality
Code
Description
License number
State
331L00000X
Blood Bank
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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