| NPI | 1619972239 |
|---|---|
| Former Legal Business Name | SOURCE ONE MEDICAL INC |
| Entity Type | Organization |
| Authorized Contact | DENNIS KLINE President/CEO 888-447-9056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: CA 103616) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2012-05-14 |