| NPI | 1538663109 |
|---|---|
| Former Legal Business Name | SOURCEMD, LLC |
| Entity Type | Organization |
| Authorized Contact | DAVID R WAGNER President/Managing Member 410-431-0144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-11-07 |