MEDICARE: CONNECTED SOURCE COURIER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1356184089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED SOURCE COURIER LLC

Provider Business Mailing Address
First Line	:	1213 W MOREHEAD ST STE 500
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28208-5581
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 S CHURCH ST APT 2711
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-3332
Country	:	US
Telephone Number	:	980-309-5118
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. BRITTANY REESE
Credential	:
Telephone Number	:	980-309-5118

Provider Enumeration Date	:	06/18/2024
Last Update Date	:	06/18/2024

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Directions to “CONNECTED SOURCE COURIER LLC ” Practice Location

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