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Organization
SOURCE MEDICAL SERVICES LLC
Active
Organization
SOURCE MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS D BIANCO (PRESIDENT)
(678) 492-1492
Entity
Organization
Contact information
Practice address
3801 SW 47TH AVE STE 502, DAVIE, FL 33314-2816
(954) 444-2961
Mailing address
3801 SW 47TH AVE STE 502, DAVIE, FL 33314-2816
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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