Organization
SOURCE DIRECT MEDICAL SUPPLY, INC
Active
Organization
SOURCE DIRECT MEDICAL SUPPLY, INC
Active
Other names
Source Direct Medical Supply, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLINE JACKSON (PRESIDENT)
(219) 472-8091
Entity
Organization
Contact information
Practice address
509 W 84TH DR STE C, MERRILLVILLE, IN 46410-5694
(219) 472-8091
Mailing address
509 W 84TH DR STE C, MERRILLVILLE, IN 46410-5694
(219) 472-8091
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
06/02/2025
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