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Organization
MEDSOURCE MD, INC.
Active
Organization
MEDSOURCE MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY L MAYNARD SR. (VICE PRESIDENT)
(216) 289-9112
Entity
Organization
Contact information
Practice address
27801 EUCLID AVE, SUITE 550, EUCLID, OH 44132-3549
(216) 289-9112
(216) 731-8545
Mailing address
27801 EUCLID AVE, SUITE 550, EUCLID, OH 44132-3549
(216) 289-9112
(216) 731-8545
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
35-055749
OH
Other
Enumeration date
07/22/2008
Last updated
12/10/2008
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