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General NPI Number Information
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NPI Number | 1811227721
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Entity Type | Organization
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Legal Business Name | TOP SOURCE MEDICAL SUPPLIES & EQUIPMENTS
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 9550 FOREST LN STE. 108
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City | DALLAS
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State | TX
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Zip | 75243-5991
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Country | US
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Telephone | 214-340-1112
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Fax | 214-221-9195
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Provider Business Mailing Address
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Address Line | 9550 FOREST LN STE. 108
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City | DALLAS
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State | TX
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Zip | 75243-5991
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Country | US
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Telephone | 214-340-1112
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Fax | 214-221-9195
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Authorized Official
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Title or Position | OWNER
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Name | CLEMENTINA N OKOYE
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Credential |
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Telephone | 214-340-1112
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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 | 1000183
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License Number State | TX
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