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Organization

MEDISOURCE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JERRY R STEELE (OWNER)
(949) 412-2639
Entity
Organization

Contact information

Practice address
555 N EL CAMINO REAL, A376, SAN CLEMENTE, CA 92672-6740
(949) 412-2639
(888) 500-0171
Mailing address
555 N EL CAMINO REAL, A376, SAN CLEMENTE, CA 92672-6740
(949) 412-2639
(888) 500-0171

Taxonomy

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

Other

Enumeration date
01/16/2013
Last updated
01/16/2013
About Stedi
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  • EDI platform