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General NPI Number Information
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NPI Number | 1275626822
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Entity Type | Organization
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Legal Business Name | HEALTHSOURCE, LLC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1000 HAMPTON CTR STE B
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City | MORGANTOWN
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State | WV
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Zip | 26505-3315
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Country | US
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Telephone | 304-598-5975
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Fax | 304-598-0228
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Provider Business Mailing Address
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Address Line | 162 INDUSTRY DR
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City | PITTSBURGH
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State | PA
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Zip | 15275-1014
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Country | US
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Telephone | 412-226-9707
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Fax | 412-618-5477
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Authorized Official
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Title or Position | COO/PRESIDENT
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Name | HEATHER ANN EDMUNDS
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Credential |
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Telephone | 412-226-9707
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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 |
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License Number State |
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