Organization
LIFE SOURCE MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GORGI NAUMOVSKI (VP PRESIDENT)
(618) 571-1005
Entity
Organization
Contact information
Practice address
377 S SWING RD, GREENSBORO, NC 27409-2009
(336) 316-1166
(336) 316-1144
Mailing address
377 S SWING RD, GREENSBORO, NC 27409-2009
(336) 316-1166
(336) 316-1144
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704697
—
NC
Enumeration date
07/28/2007
Last updated
09/21/2016
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