Organization
1 SOURCE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANILDA TORRES (CEO)
(856) 691-1510
Entity
Organization
Contact information
Practice address
1068 E LANDIS AVE, SUITE A, VINELAND, NJ 08360-4042
(856) 691-1510
(856) 692-1389
Mailing address
1068 E LANDIS AVE, SUITE A, VINELAND, NJ 08360-4042
(856) 691-1510
(856) 692-1389
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
NJ
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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