SRC, LP

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

3000269 Issued in IL

Legal business name

SRC, LP

Practice address

311 E Main St
Suite 202
Galesburg, IL 61401-4855

Phone

(309) 228-4222

Fax

(866) 557-9176

NPI assigned

Nov 18, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey Adam Salter

Title

President

Phone

(210) 757-4650

Specialties & licenses 1

Addresses

Other names 1

• Caring Senior Service of Galesburg Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1003144791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E PARK AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 E MAIN ST",
            "address_2": "SUITE 202",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614014855",
            "telephone_number": "309-228-4222",
            "fax_number": "866-557-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRC, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "SALTER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-757-4650"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "3000269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caring Senior Service of Galesburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.