SOURCE ONE MEDICAL INC (NPI# 1750388252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750388252 |
| Entity Type | Organization |
| Organization Name | SOURCE ONE MEDICAL INC |
| Other Organization Name | SOURCE ONE MEDICAL INC |
| Practice Address |
2121 New Market Pkwy Se Suite 108 Marietta GA 30067-9315 |
| Mailing Address |
38 Tesla Suite 150 Irvine CA 92618-4670 |
| Practice Telephone | 8884479056 |
| Practice Fax Number | 8005881253 |
| Mailing Telephone | 8884479056 |
| Mailing Fax Number | 8005881253 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-05-27 |
| Authorized Official Name | DENNIS KLINE (PRESIDENT/CEO) |
| 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 |
|---|---|---|---|---|
| 1679736888 | Source One Medical Inc | Durable Medical Equipment & Medical Supplies | 6280 S Valley View Blvd, Suite 220, Las Vegas, NV 89118-3809 | 2008-07-08 |
| 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 |
| 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 |
2121 NEW MARKET PKWY SE SUITE 108 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30067-9315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093346165 | Kennedi Thompson | Behavior Technician | 2121 New Market Pkwy Se, Marietta, GA 30067-9315 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140022 | Sherry Wilson King | Marriage & Family Therapist | 1640 Powers Ferry Rd Blg 7, Ste 300, Marietta, GA 30067 | 2018-10-23 |
| 1053886861 | Precious Angel Home Care Services Inc | Adult Companion | 2470 Windy Hill Road, Marietta, Suite 253, Marietta, GA 30067 | 2018-10-08 |
| 1194206466 | Joshua P Moree | Chiropractor | 860 Franklin Gtwy Se Apt 111, Marietta, GA 30067 | 2018-08-24 |
| 1841778081 | Sun Pediatrics LLC | Pediatrics | 2520 Windy Hill Rd Se Ste 104, Marietta, GA 30067 | 2018-07-31 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1497254213 | Allison M Jancik | Chiropractor | 1355 Terrell Mill Road Se, Bldg 1474, Ste 150, Marietta, GA 30067 | 2018-02-07 |
| 1801304969 | Danielle Ann Dietrich | Chiropractor | 805 Winterset Pkwy Se, Marietta, GA 30067 | 2018-01-11 |
| 1740794866 | Jessica Lofgren | Chiropractor | 1130 Northchase Pkwy Se Ste 125, Marietta, GA 30067 | 2017-11-28 |
| 1871026393 | Rhonda Dawes Milner | Counselor | 1640 Powers Ferry Rd Bldg 16, Suite 100, Marietta, GA 30067 | 2017-04-11 |
| 1457894537 | Carcelia Delk | Counselor | 1110 Augusta Dr Se, Marietta, GA 30067 | 2016-11-22 |
| Find all providers in zip 30067 | ||||
| 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 |
|---|---|---|---|---|
| 1164045548 | My Chronic Care Management | Durable Medical Equipment & Medical Supplies | 20 Whitlock Pl Sw Ste 101, Marietta, GA 30064-3176 | 2020-05-20 |
| 1508495953 | Sns Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 631 Campbell Hill St Nw Ste 100, Marietta, GA 30060-1390 | 2020-04-07 |
| 1679125538 | Ogles Oxygen, LLC | Durable Medical Equipment & Medical Supplies | 1890 W Oak Pkwy Ste A, Marietta, GA 30062-2278 | 2019-07-11 |
| 1609338326 | Green Wood Berry Holdings LLC | Durable Medical Equipment & Medical Supplies | 509 Gramercy Dr Ne, Marietta, GA 30068-4873 | 2019-04-02 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1487183224 | Damon Iler | Durable Medical Equipment & Medical Supplies | 428 Marble Mill Rd Nw Unit A, Marietta, GA 30060 | 2017-06-06 |
| 1659825198 | Lonnie Johnson | Durable Medical Equipment & Medical Supplies | 1750 Powder Springs Rd Sw Ste 190, Marietta, GA 30064-4861 | 2016-08-13 |
| 1316334261 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 718 Cherokee St, Marietta, GA 30060-7253 | 2015-04-17 |
| 1760872923 | Advanced Home Care Inc | Durable Medical Equipment & Medical Supplies | 800 Whitlock Ave Nw, Ste 126, Marietta, GA 30064-4664 | 2015-01-27 |
| 1003212457 | Zenartis Health Services LLC | Durable Medical Equipment & Medical Supplies | 1110 Northchase Pkwy Se, Suite 180, Marietta, GA 30067-6408 | 2014-11-13 |
| Find all providers in MARIETTA | ||||
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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.