Organization
SENIOR SOURCE ONE MEDICAL SUPPLIES AND SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRIS EVERSON (OWNER)
(404) 422-6659
Entity
Organization
Contact information
Practice address
1426 WOODLAND TER SW, ATLANTA, GA 30311-3224
(404) 422-6659
Mailing address
1426 WOODLAND TER SW, ATLANTA, GA 30311-3224
(404) 422-6659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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