Organization
ACTION MEDSOURCE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BLAINE RICHARDS (MANAGER)
(903) 530-4791
Entity
Organization
Contact information
Practice address
709 HOLLYBROOK DR, SUITE 3401, LONGVIEW, TX 75605-2411
(903) 530-4791
Mailing address
PO BOX 131416, TYLER, TX 75713-1416
(903) 530-4791
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/12/2007
Last updated
08/22/2020
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