SOURCEONE MEDICAL INC (NPI# 1235329616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235329616 |
| Entity Type | Organization |
| Organization Name | SOURCEONE MEDICAL INC |
| Other Organization Name | SOURCEONE MEDICAL INC |
| Practice Address |
1872 Craigshire Rd Saint Louis MO 63146-4006 |
| Mailing Address |
38 Tesla Suite 150 Irvine CA 92618-4670 |
| Practice Telephone | 3142757733 |
| Practice Fax Number | 3142757708 |
| Mailing Telephone | 8884479056 |
| Mailing Fax Number | 8888450938 |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-11-02 |
| Authorized Official Name | MR. FRANK BRYAN (ADM OFFICE MGR) |
| Authorized Official Telephone | 8884479056 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
42145 | MO | Suppliers |
| Other Name | Type Code |
|---|---|
| SourceOne Medical Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396898037 | Sourceone Medical Inc | Durable Medical Equipment & Medical Supplies | 7216 Washington St Ne Ste F, Albuquerque, NM 87109-4514 | 2007-01-18 |
| 1689642191 | Sourceone Medical Inc | Durable Medical Equipment & Medical Supplies | 5028 S Ash Ave, Tempe, AZ 85282-6848 | 2006-03-09 |
| 1023086535 | Sourceone Medical Inc | Durable Medical Equipment & Medical Supplies | 6160 Sw Arctic Dr, Beaverton, OR 97005-9448 | 2006-03-09 |
| 1982679056 | Sourceone Medical Inc | Durable Medical Equipment & Medical Supplies | 167 W 7065 S, Midvale, UT 84047-3717 | 2006-02-21 |
| 1871594101 | Sourceone Medical Inc | Durable Medical Equipment & Medical Supplies | 30 Main Ave, Sacramento, CA 95838-2036 | 2005-08-09 |
| Street Address |
1872 CRAIGSHIRE RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63146-4006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553118 | Chelsea Ann Garbs | Nurse Practitioner | 1249 Woodland Point Dr Unit E, St. Louis, MO 63146 | 2020-09-17 |
| 1538790647 | Supreme Quality Care LLC | Home Health | 111 West Port Plaza, Floor 6, Maryland Heights, MO 63146 | 2020-01-28 |
| 1942854492 | Winning Hands Home Health Care Services LLC | In Home Supportive Care | 12738 Fee Fee Rd, Saint Louis, MO 63146 | 2019-08-01 |
| 1144883893 | Tylians T Smith | Physical Therapy Assistant | 12544 Fee Fee Rd, Saint Louis, MO 63146 | 2019-04-18 |
| 1528533049 | Veterans Home Care, LLC | Durable Medical Equipment & Medical Supplies | 11861 Westline Industrial Drive, Suite 750, St. Louis, MO 63146 | 2018-10-11 |
| 1417433558 | Alexandria Marie Falck | Pharmacist | 577 Mid Rivers Mall Drive, Saint Louis, MO 63146 | 2018-07-12 |
| 1043702897 | Equal Shares Parenting, LLC | Marriage & Family Therapist | 10313 Corbeil Dr., Unit D, St. Louis, MO 63146 | 2018-06-06 |
| 1588189930 | Anita Shawke | Physical Therapist | 11960 Westline Industrial Drive, Suite 201, St. Louis, MO 63146 | 2017-08-07 |
| 1174047005 | Midwest Spine & Injury Centers, Inc. | Chiropractor | 2108 Schuetz Road, Maryland Heights, MO 63146 | 2017-08-02 |
| 1447700604 | Compassus Op of Missouri LLC | Hospice Care, Community Based | 11872 Westline Industrial Dr Ste 160, Saint Louis, MO 63146 | 2016-10-11 |
| Find all providers in zip 63146 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881240349 | Jerry Lee Long Jr. | Durable Medical Equipment & Medical Supplies | 6654 Bitteroot Ln, Saint Louis, MO 63134-1451 | 2019-08-12 |
| 1417252602 | Medcuro Manufacturing, LLC | Durable Medical Equipment & Medical Supplies | 9959 Lin Ferry Dr, Saint Louis, MO 63123-6913 | 2011-01-19 |
| 1184885188 | James Allen Cohen | Durable Medical Equipment & Medical Supplies | 99 Lake Forest Dr, Saint Louis, MO 63117-1361 | 2008-06-23 |
| 1013102334 | Kreg Therapeutics, Inc. | Durable Medical Equipment & Medical Supplies | 11040 Lin Valle Dr, Suite E, Saint Louis, MO 63123-7210 | 2007-09-10 |
| 1013136720 | United Access LLC | Durable Medical Equipment & Medical Supplies | 9389 Natural Bridge Rd, Saint Louis, MO 63134-3145 | 2007-04-24 |
| 1689673493 | Midwest Stone Institute | Durable Medical Equipment & Medical Supplies | 12166 Old Big Bend Rd Ste 110, Saint Louis, MO 63122-6836 | 2005-07-14 |
| 1407852577 | Support Surfaces, Inc | Durable Medical Equipment & Medical Supplies | 10770 Midwest Industrial Blvd, Saint Louis, MO 63132-1610 | 2005-06-23 |
| 1447788823 | Custom Medical Solutions Inc | Durable Medical Equipment & Medical Supplies | 10770 Midwest Industrial Blvd, Saint Louis, MO 63132-1610 | 2017-05-30 |
| 1053850909 | Wolken Dental D D S P C | Durable Medical Equipment & Medical Supplies | 8888 Ladue Rd, Saint Louis, MO 63124-2056 | 2017-02-13 |
| 1487104600 | Bruce Cook Prosthetics | Durable Medical Equipment & Medical Supplies | 2821 N Ballas Rd, Suite 215, Saint Louis, MO 63131-2321 | 2016-10-12 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63146 |
Please comment or provide details below to improve the information on SOURCEONE MEDICAL INC.
| 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.