Organization Name: | 1 SOURCE MEDICAL EQUIP & SUPPLIES, INC. |
NPI Number: | 1578519039 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRANDI LOPES (OWNER) |
Mailing Address: | 305 E Mckinley Ave Mishawaka |
State: | IN US |
Postal Code: | 465456212 |
Phone Number: | 5742555002 |
Fax Number: | |
NPI Enumeration Date: | 05/26/2006 |
NPI Last Update Date: | 06/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 0122739876 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |