Organization
TARASOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORBERT A BENNETT (CO-CEO)
(716) 662-4955
Entity
Organization
Contact information
Practice address
3690 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1720
(716) 662-4955
(716) 667-9230
Mailing address
3690 SOUTHWESTERN BLVD, PO BOX 0428, ORCHARD PARK, NY 14127
(716) 662-4955
(716) 972-0338
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
08/12/2008
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