Organization · Type 2 NPI
Medisource Home Medical
Customized Equipment (DME) · Kennesaw, GA
NPI number
1770501736
Active
Practice location
975 Cobb Place Blvd NW Ste 113
Kennesaw, GA 30144-6848
Fax (770) 528-9309
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | None listed |
| Customized Equipment (DME) Primary | 332BC3200X | None listed |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | None listed |
Customized Equipment (DME): Definition to come...
Other customized equipment (dme) providers in Kennesaw
About NPI 1770501736
Medisource Home Medical's National Provider Identifier is 1770501736, issued on Jul 18, 2006. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Kennesaw, GA. The record was last updated on Oct 13, 2020.