One Source Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ONE SOURCE MEDICAL SUPPLY

Practice address

19606 Linden Blvd
Saint Albans, NY 11412-3246

Phone

(718) 977-1070

Fax

(718) 228-7114

NPI assigned

Feb 29, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Alida Fouche

Title

Office MGR

Phone

(718) 977-1070

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1053685610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19606 LINDEN BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123246",
            "telephone_number": "718-977-1070",
            "fax_number": "718-977-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19606 LINDEN BLVD",
            "city": "SAINT ALBANS",
            "state": "NY",
            "postal_code": "114123246",
            "telephone_number": "718-977-1070",
            "fax_number": "718-228-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "FOUCHE",
        "authorized_official_first_name": "ALIDA",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "718-977-1070",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Saint Albans, NY
• Providers in Saint Albans, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.