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Organization
ONE SOURCE MEDICAL GROUP LLC
Active
Organization
ONE SOURCE MEDICAL GROUP LLC
Active
Parent organization
ONE SOURCE MEDICAL GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONE SOURCE MEDICAL GROUP LLC
Authorized official
DANIEL J JONATHAN ROBICHAUD (CEO)
(866) 834-7473
Entity
Organization
Contact information
Practice address
4848 PERRIN CRK STE 680, SAN ANTONIO, TX 78217-3744
(866) 834-7473
(877) 490-9111
Mailing address
13910 LYNMAR BLVD, TAMPA, FL 33626-3123
(866) 834-7473
(877) 490-9111
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
Other
Enumeration date
04/24/2012
Last updated
02/22/2024
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