SOURCE ONE MEDICAL INC (NPI# 1679736888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679736888 |
| Entity Type | Organization |
| Organization Name | SOURCE ONE MEDICAL INC |
| Other Organization Name | SOURCE ONE MEDICAL INC |
| Practice Address |
6280 S Valley View Blvd Suite 220 Las Vegas NV 89118-3809 |
| Mailing Address |
38 Tesla Suite 150 Irvine CA 92618-4670 |
| Practice Telephone | 8884479056 |
| Practice Fax Number | 8888450838 |
| Mailing Telephone | 8884479056 |
| Mailing Fax Number | 8888450938 |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |
| Authorized Official Name | FRANK BRYAN (ADM OFFICE MGR) |
| Authorized Official Telephone | 8884479056 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Source One Medical Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568653871 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 38 Tesla, Suite 150, Irvine, CA 92618-4669 | 2007-08-05 |
| 1679661870 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 1397 Piedmont Dr, Ste 300, Troy, MI 48083-1906 | 2006-10-11 |
| 1578672374 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 7551 W 99th St, Bridgeview, IL 60455-2403 | 2006-08-29 |
| 1881703684 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 2124 S 156th Cir, Omaha, NE 68130-2503 | 2006-08-29 |
| 1982673257 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 6886 Hillsdale Ct, Indianapolis, IN 46250-2001 | 2006-03-17 |
| 1043289176 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 411 Ironwood Dr, Salt Lake City, UT 84115-2948 | 2006-03-14 |
| 1275530784 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 96 Inverness Dr E, Unit D, Englewood, CO 80112-5302 | 2005-06-30 |
| 1750388252 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 2121 New Market Pkwy Se, Suite 108, Marietta, GA 30067-9315 | 2005-06-30 |
| 1619972239 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 16 Technology Dr, Suite 165, Irvine, CA 92618-2328 | 2005-06-20 |
| 1548416043 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 7551 W 99th St, Bridgeview, IL 60455-2403 | 2008-08-15 |
| Street Address |
6280 S VALLEY VIEW BLVD SUITE 220 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89118-3809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932643657 | Dedicated Caring Medical Transportation, LLC | Non-emergency Medical Transport (VAN) | 6280 S Valley View Blvd, Suite 723, Las Vegas, NV 89118-3809 | 2016-12-14 |
| 1316353089 | Mssd LLC | Clinic/Center | 6280 S Valley View Blvd, Suite 721, Las Vegas, NV 89118-3809 | 2014-07-02 |
| 1922340561 | Lbo LLC | In Home Supportive Care | 6280 S Valley View Blvd, Suite 721, Las Vegas, NV 89118-3809 | 2013-03-21 |
| 1750685061 | Dks Services | Home Health | 6280 S Valley View Blvd, Suite #522, Las Vegas, NV 89118-3809 | 2010-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720568520 | Kurt Yaross | Behavioral Analyst | 7138 W Post Rd, #208, Las Vegas, NV 89118 | 2018-08-21 |
| 1619457108 | Michelle Herzberg | Behavioral Analyst | 7318 W Post Rd #280, Las Vegas, NV 89118 | 2018-08-15 |
| 1548749385 | Keisha Bere-ruiz | Behavioral Analyst | 7318 W Post Rd #208, Las Vegas, NV 89118 | 2018-08-13 |
| 1295222081 | Aliantcare | Radiologic Technologist | 5490 S Rainbow Blvd, Suite 400 N34835, Las Vegas, NV 89118 | 2018-04-17 |
| 1710406467 | Anoush H. Tacvorian Do LLC | Clinic/Center | 6525 W. Warm Springs Rd, Suite 100, Las Vegas, NV 89118 | 2017-09-13 |
| 1962920470 | Harvard Medtech, LLC | Durable Medical Equipment & Medical Supplies | 6280 S. Valley View Blvd, Suite 412, Las Vegas, NV 89118 | 2017-09-05 |
| 1750827903 | Kerry Cutler | Nurse Practitioner | 6020 South Rainbow Blvd, Suite C, Las Vegas, NV 89118 | 2017-01-12 |
| 1184173015 | Girisgen & Kopolow Od PC | Optometrist | 7090 S Rainbow Blvd, Ste 100, Las Veegas, NV 89118 | 2016-10-04 |
| 1396117859 | Foundation for Positively Kids | Clinic/Center | 3555 E Reno, Ste F, Las Vegas, NV 89118 | 2015-10-23 |
| 1720492663 | Kiet Michael Lam | Chiropractor | 5693 S. Jones Bvld, Ste 116, Las Vegas, NV 89118 | 2014-06-18 |
| Find all providers in zip 89118 | ||||
| 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 |
|---|---|---|---|---|
| 1811595622 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2500 W Washington Ave Ste 103, Las Vegas, NV 89106-3731 | 2020-10-14 |
| 1639793698 | Amador Medical LLC | Durable Medical Equipment & Medical Supplies | 4325 Dean Martin Dr Ste 340, Las Vegas, NV 89103-4168 | 2020-06-04 |
| 1205456001 | Vitality M12 LLC | Durable Medical Equipment & Medical Supplies | 4650 Arville St Ste F, Las Vegas, NV 89103-5325 | 2020-04-21 |
| 1255951059 | Peggy Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 6355 S Durango Dr Unit 1265, Las Vegas, NV 89113-1878 | 2020-04-21 |
| 1598394801 | Total Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 200 Hoover Ave Unit 1912, Las Vegas, NV 89101-6887 | 2020-04-07 |
| 1033743083 | Summerlin Medical | Durable Medical Equipment & Medical Supplies | 10300 W. Charleston Blvd., Suite 13, Las Vegas, NV 89135 | 2020-02-28 |
| 1053959791 | Wound Pros Nevada | Durable Medical Equipment & Medical Supplies | 5940 S Rainbow Blvd Ste 2007, Las Vegas, NV 89118-2506 | 2019-12-12 |
| 1841835618 | Home Front Pumps West | Durable Medical Equipment & Medical Supplies | 11239 Cactus Tower Ave Unit 101, Las Vegas, NV 89135-3449 | 2019-11-15 |
| 1568016855 | Medelite Capital, LLC | Durable Medical Equipment & Medical Supplies | 5528 S Fort Apache Rd, Las Vegas, NV 89148-7657 | 2019-07-25 |
| 1376004614 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2780 S Jones Blvd Ste 140, Las Vegas, NV 89146-5641 | 2019-03-28 |
| Find all providers in LAS VEGAS | ||||
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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.