Medsource Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDSOURCE INC.

Practice address

10520 S 700 E Ste 210
Sandy, UT 84070-0943

Phone

(801) 771-3939

Fax

(888) 828-8290

NPI assigned

Sep 13, 2005

Organization subpart

No

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

Authorized official

Name

Mr. David Charles

Title

President

Phone

(801) 771-3939

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1164417366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10520 S 700 E STE 210",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840700943",
            "telephone_number": "801-771-3939",
            "fax_number": "888-506-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10520 S 700 E STE 210",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840700943",
            "telephone_number": "801-771-3939",
            "fax_number": "888-828-8290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10520 S 700 E Ste 210",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840700943",
            "country_code": "US",
            "telephone_number": "801-771-3939",
            "fax_number": "888-506-2344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDSOURCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-771-3939",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Megan Komatsu Inc.
• Dzenis Mehinovic, CRNA

• Durable Medical Equipment & Medical Supplies in Sandy, UT
• Providers in Sandy, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.