Organization
ONE SOURCE MEDICAL SUPPLY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESHUN I FAYE (OWNER)
(718) 880-0437
Entity
Organization
Contact information
Practice address
13447 166TH PL, SUITE 4G, JAMAICA, NY 11434-3853
(718) 880-0437
Mailing address
13447 166TH PL, SUITE 4G, JAMAICA, NY 11434-3853
(718) 880-0437
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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