MEDSOURCE, LLC (NPI# 1093892044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093892044 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE, LLC |
| Practice Address |
3002 Gill Street Bloomington IL 61704-3438 |
| Mailing Address |
P.o. Box 1248 Bloomington IL 61702-1248 |
| Practice Telephone | 8885105100 |
| Practice Fax Number | 8885105200 |
| Mailing Telephone | 8885105100 |
| Mailing Fax Number | 8885105200 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-08-15 |
| Authorized Official Name | MR. ERIC ROHDE (OWNER) |
| Authorized Official Telephone | 8885105100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 203.000461 | IL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801300058 | Medsource, LLC | Durable Medical Equipment & Medical Supplies | 1802 Chapel Hills Dr Ste D, Colorado Springs, CO 80920-3736 | 2017-11-27 |
| 1487886537 | Medsource, LLC | Specialist | 3909 Midlands Road, Suite: B, Williamsburg, VA 23188 | 2009-08-21 |
| 1194897553 | Medsource, LLC | Nursing Care | 33 N Garden Ave Ste 800, Clearwater, FL 33755-6614 | 2006-11-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | MedSource, LLC | 33 N. Garden Avenue, Suite 800, Clearwater, FL 33755 |
| Connecticut Business Registrations | MEDSOURCE, LLC | 701 Enterprise Road, Suite 601, Safety Harbor, FL 34695 |
| Street Address |
3002 GILL STREET |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61704-3438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518430859 | Visionpoint Eye Center LLC | Optometrist | 1107 Airport Road, Bloomington, IL 61704 | 2019-01-09 |
| 1922588235 | Geethu Sabu Makil | Speech-Language Pathologist | 1039 Blueheron Way, Apt#3, Bloomington, IL 61704 | 2018-08-16 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1649798513 | Sarah Goodner | Psychologist | 1704 Royal Pointe Drive, Bloomington, IL 61704 | 2017-08-31 |
| 1346760253 | Elizabeth Devlin | Nurse Practitioner | 25 Long Cove Ct, Bloomington, IL 61704 | 2017-06-21 |
| 1396107918 | Darla Schwertfeger | Specialist/Technologist, Other | 2104 Hedgewood Dr, Bloomington, IL 61704 | 2016-03-23 |
| 1740662949 | Oncology Hematology Associates of Central Illinois | Pharmacy | 3105 Magory Drive, Bloomington, IL 61704 | 2015-06-24 |
| 1821478967 | Kelly R Andrews | Massage Therapist | 4101 Wicker Rd, Bloomington, IL 61704 | 2015-06-03 |
| 1235522582 | All Ways Caring Services, Inc. | In Home Supportive Care | 209 S Prospect Rd, Suite 3e, Bloomington, IL 61704 | 2015-03-11 |
| 1396093977 | Bhawna Gupta | Physical Therapist | 2200 East Washington Street, Bloomington, IL 61704 | 2012-08-29 |
| Find all providers in zip 61704 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245797646 | D B Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 2601 General Electric Rd Ste 4, Bloomington, IL 61704-3437 | 2019-02-22 |
| 1538648571 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 702 W Chestnut St Ste 103, Bloomington, IL 61701-2814 | 2018-08-10 |
| 1881193274 | Orthopedic Rehabilitation Supply LLC | Durable Medical Equipment & Medical Supplies | 13 Norbloom Ave, Bloomington, IL 61701-1949 | 2018-02-12 |
| 1821504697 | Wig Wam Boutique LLC | Durable Medical Equipment & Medical Supplies | 313 W 17th St, Bloomington, IN 47404-3453 | 2017-12-15 |
| 1033622824 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 1825 N Kinser Pike, Bloomington, IN 47404-1914 | 2017-11-15 |
| 1629509732 | Touchway LLC | Durable Medical Equipment & Medical Supplies | 60 E Broadway, Bloomington, MN 55425-5510 | 2017-03-22 |
| 1437697935 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 445 S Landmark Ave Ste P, Bloomington, IN 47403-5004 | 2017-02-03 |
| 1861875403 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 121 E Kirkwood Ave, Bloomington, IN 47408-3331 | 2015-07-01 |
| 1639479140 | Home Health Depot | Durable Medical Equipment & Medical Supplies | 13 Westport Ct, Unit B, Bloomington, IL 61704-3626 | 2010-10-31 |
| 1316178064 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1130 S Veterans Pkwy, Bloomington, IL 61704 | 2009-07-29 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61704 |
Please comment or provide details below to improve the information on MEDSOURCE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.