Organization
SINGLE SOURCE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY R PETERSEN (MANAGING MEMBER)
(916) 631-1236
Entity
Organization
Contact information
Practice address
2868 PROSPECT PARK DR, SUITE 600, RANCHO CORDOVA, CA 95670-6020
(916) 631-1236
(916) 636-9787
Mailing address
2868 PROSPECT PARK DR, SUITE 600, RANCHO CORDOVA, CA 95670-6020
(916) 631-1236
(916) 636-9787
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/26/2009
Last updated
09/26/2009
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