| Organization Name: | CARDIOSOM, LLC |
| NPI Number: | 1114937893 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAY JARRELL (PRESIDENT/COO) |
| Mailing Address: | 17527 River Road Noblesville |
| State: | IN US |
| Postal Code: | 460628528 |
| Phone Number: | 3172193360 |
| Fax Number: | 3172193335 |
| NPI Enumeration Date: | 08/08/2006 |
| NPI Last Update Date: | 08/10/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 69000012A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |