Organization Name: | ONE SOURCE MEDICAL GROUP LLC |
NPI Number: | 1366653545 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT MUELLER (PRESIDENT) |
Mailing Address: | 13505 Icot Blvd Ste 209 Clearwater |
State: | FL US |
Postal Code: | 337603730 |
Phone Number: | 8137923560 |
Fax Number: | 8774909111 |
NPI Enumeration Date: | 05/27/2007 |
NPI Last Update Date: | 08/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1313496 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |