Organization
FIRST SOURCE CATHETER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS MALCOM (PRESIDENT)
(470) 839-2904
Entity
Organization
Contact information
Practice address
1690 REDI RD, SUITE 400, CUMMING, GA 30040-9704
(470) 839-2904
(470) 839-2179
Mailing address
1690 REDI RD, SUITE 400, CUMMING, GA 30040-9704
(470) 839-2904
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003199056A
—
GA
Enumeration date
03/02/2017
Last updated
03/26/2018
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