Organization
ONE SOURCE SURGICAL SUPPLIES LLC
Active
Other names
White Plains Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAYANT K THAKER R.PH. (CHIEF EXECUTIVE OFFICER)
(914) 948-4878
Entity
Organization
Contact information
Practice address
1 WINCHESTER RD, WHITE PLAINS, NY 10601
(914) 948-4878
(866) 486-4959
Mailing address
PO BOX 72, WHITE PLAINS, NY 10602-0072
(914) 948-4878
(866) 486-4959
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
769733
ANCILLARY PROVIDER
NY
Enumeration date
05/19/2021
Last updated
01/05/2026
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