Organization
SOURCEONE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA JANSSEN (ADM OFFICE MANAGER)
(888) 447-9056
Entity
Organization
Contact information
Practice address
167 W 7065 S, MIDVALE, UT 84047-3717
(801) 307-0758
(801) 307-0765
Mailing address
1 PETERS CANYON RD, IRVINE, CA 92606-1400
(888) 447-9056
(888) 845-0838
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
602330-1714
UT
Other
Enumeration date
02/21/2006
Last updated
08/22/2020
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