MEDSOURCE, LLC. (NPI# 1316207590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316207590 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE, LLC. |
| Practice Address |
432 Mack Smith Rd Rossville GA 30741-3792 |
| Mailing Address |
Po Box 1248 Bloomington IL 61702-1248 |
| Practice Telephone | 8885105100 |
| Practice Fax Number | 8885105200 |
| Mailing Telephone | 3096647930 |
| Mailing Fax Number | 8885105200 |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-06-27 |
| Authorized Official Name | MR. ERIC ROHDE (OWNER) |
| Authorized Official Telephone | 3096647930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| 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 |
432 MACK SMITH RD |
| City | ROSSVILLE |
| State | GA |
| Zip Code | 30741-3792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881084549 | Bi-lo Pharmacy | Pharmacy | 820 Misson Ridge Road, Rossville, GA 30741 | 2015-02-02 |
| 1013194943 | Kathleen Marie Powell | Physical Therapist | 1425 Mc Farland Ave, Rossville, GA 30741 | 2008-01-22 |
| 1871668020 | Jerry Vance Grimmitt | Pharmacist | 785 Chickamauga Av, Longley Pharmacy, Rossville, GA 30741 | 2006-11-22 |
| 1831163898 | Jose R Justiniano-ayala | Family Medicine | 205 Jenkins Rd, Rossville, GA 30741 | 2006-02-15 |
| 1235389230 | Michael Robert Mccoy | Internal Medicine | 205 Jenkins Rd, Rossville, GA 30741 | 2008-09-25 |
| 1255512182 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 205 Jenkins Rd, Rossville, GA 30741 | 2007-11-20 |
| 1962677633 | Lookout Mountain Community Service | Community/Behavioral Health | 405 Glenn Wade Dr, Rossville, GA 30741-1176 | 2008-04-24 |
| 1033142930 | Robert Alan Stultz | Physician Assistant | 118 Howard St, Rossville, GA 30741-1314 | 2006-07-07 |
| 1902950462 | Leisha Harrell Espy | Chiropractor | 100 E Gordon Ave, Rossville, GA 30741-1318 | 2007-01-22 |
| 1073687596 | Rocky Top Pharmacy Inc | Pharmacy | 785 Chickamauga Ave, Rossville, GA 30741-1404 | 2006-11-17 |
| Find all providers in zip 30741 | ||||
| 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 |
|---|---|---|---|---|
| 1760850085 | K Va T Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 820 Mission Ridge Rd, Rossville, GA 30741-4246 | 2015-09-03 |
| 1346304441 | Arnett Clinic, LLC | Durable Medical Equipment & Medical Supplies | 14 S Plank St, Rossville, IN 46065-9437 | 2006-12-21 |
| 1629131552 | Quality Living Aids | Durable Medical Equipment & Medical Supplies | 916 Lafayette Rd, Suite C, Rossville, GA 30741-2071 | 2006-12-19 |
| 1356410062 | Bretts Shoes and Vanity Fair | Durable Medical Equipment & Medical Supplies | 1600 Mcfarland Ave, Rossville, GA 30741-2266 | 2006-11-07 |
| 1316027691 | American Oxygen & Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 61 W Main St, Rossville, IN 46065-9459 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1659986776 | Carmichael Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 2950 Cherokee St Nw Ste 620, Kennesaw, GA 30144-6505 | 2020-09-15 |
| 1699380030 | Capstone Hme Inc | Durable Medical Equipment & Medical Supplies | 1129 Mente Dr, Savannah, GA 31415-3104 | 2020-09-12 |
| 1740895580 | Home Delivery Incontinent Supplies Co Inc | Durable Medical Equipment & Medical Supplies | 801 Broad St Ste 602, Augusta, GA 30901-1227 | 2020-09-09 |
| 1821602202 | Mcgarity Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3081 Stone Mountain St Ste A, Lithonia, GA 30058-4426 | 2020-09-03 |
| 1265044150 | Getwell Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 310 Glynn St N Ste B401, Fayetteville, GA 30214-1105 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
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| 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.