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Organization

1 SOURCE MEDICAL EQUIP & SUPPLIES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDI LOPES (OWNER)
(574) 255-5002
Entity
Organization

Contact information

Practice address
305 E MCKINLEY AVE, MISHAWAKA, IN 46545-6212
(574) 255-5002
Mailing address
305 E MCKINLEY AVE, MISHAWAKA, IN 46545-6212
(574) 255-5002

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0122739876
IN

Other

Enumeration date
05/26/2006
Last updated
06/13/2008
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