Organization
SOURCE ONE MEDICAL INC
Active
Other names
Source One Medical Inc
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK BRYAN (ADM OFFICE MGR)
(888) 447-9056
Entity
Organization
Contact information
Practice address
6280 S VALLEY VIEW BLVD, SUITE 220, LAS VEGAS, NV 89118-3809
(888) 447-9056
(888) 845-0838
Mailing address
38 TESLA, SUITE 150, IRVINE, CA 92618-4670
(888) 447-9056
(888) 845-0938
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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