NPI | 1063749265 |
---|---|
Doing Business As | SOURCE 1 - DME |
Entity Type | Organization |
Authorized Contact | TRACY JOHN FOX Business Owner 303-952-0396 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CO 4274647) |
Enumeration Date | 2009-11-09 |
Last Update Date | 2009-11-09 |