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General NPI Number Information
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NPI Number | 1265612782
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Entity Type | Organization
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Legal Business Name | ONE SOURCE MEDICAL SERVICE, INC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 1209 E 2ND ST
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City | SANFORD
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State | FL
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Zip | 32771-1413
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Country | US
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Telephone | 407-936-0091
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Fax | 407-936-1182
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Provider Business Mailing Address
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Address Line | PO BOX 912
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City | GOTHA
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State | FL
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Zip | 34734-0912
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Country | US
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Telephone | 407-936-0091
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Fax | 407-936-1182
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. DANIEL S. HERRINGTON
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Credential |
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Telephone | 407-936-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1293
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License Number State | FL
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