Medisource Solutions, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1374 Issued in FL

Legal business name

MEDISOURCE SOLUTIONS, LLC

Practice address

325 Fenton Rd SW
Palm Bay, FL 32908-4882

Phone

(321) 506-5688

Fax

(888) 320-0905

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Kevan Allaire Sr.

Title

Owner

Phone

(321) 506-5688

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1457788085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 FENTON RD SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084882",
            "telephone_number": "321-506-5688",
            "fax_number": "888-320-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 FENTON RD SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084882",
            "telephone_number": "321-506-5688",
            "fax_number": "888-320-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISOURCE SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "ALLAIRE",
        "authorized_official_first_name": "KEVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-506-5688",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "1374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.