Organization
MED SOURCE PLUS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK WELLS (OWNER)
(270) 926-8999
Entity
Organization
Contact information
Practice address
725 HARVARD DR # A, OWENSBORO, KY 42301-6185
(270) 926-8999
(270) 926-8450
Mailing address
725 HARVARD DR # A, OWENSBORO, KY 42301-6185
(270) 926-8999
(270) 926-8450
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332B00000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0761966
—
OH
Enumeration date
12/27/2006
Last updated
08/22/2020
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