Organization
SOURCE ONE MEDICAL INC
Active
Other names
Source One Medical Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS KLINE (PRESIDENT/CEO)
(888) 447-9056
Entity
Organization
Contact information
Practice address
2124 S 156TH CIR, OMAHA, NE 68130-2503
(888) 447-9056
(949) 387-6371
Mailing address
38 TESLA, SUITE 150, IRVINE, CA 92618-4669
(888) 447-9056
(949) 387-6371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NE
Other
Enumeration date
08/29/2006
Last updated
06/06/2011
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