Medisource Home Medical
LBN: Medisource Home Medical
Medisource Home Medical is an health care organization with primary practice located at 975 Cobb Place Blvd Nw Ste 113 , Kennesaw GA 30144-6848. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Customized Equipment, Suppliers / Oxygen Equipment & Supplies. Suppliers / Customized Equipment is the primary health care specialty.
Medisource Home Medical can be contacted via phone (770) 528-9559, or through Silva, Sergio via phone (770) 528-9559.
Contact Information
Primary practice address
975 Cobb Place Blvd Nw Ste 113
Kennesaw GA 30144-6848
Phone: (770) 528-9559
Fax: (770) 528-9309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Customized Equipment | 332BC3200X | ||
| Suppliers / Oxygen Equipment & Supplies | 332BX2000X |
Profile Details
| NPI number | 1770501736 |
|---|---|
| LBN Legal business name | Medisource Home Medical |
| DBA Doing business as | |
| Authorized official | Silva, Sergio |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Oct 13th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770501736 | NPPES |
| Georgia | Other | 52164995 | BCBS |
| Georgia | MEDICAID | 341310291A | BCBS |
| Georgia | Other | 1023735 | BCBS |
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