NPIMap

Organization Active NPI

Source One Medical Inc

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
National Provider Identifier
1679736888
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOURCE ONE MEDICAL INC
Practice address
6280 S Valley View Blvd
Suite 220
Las Vegas, NV 89118-3809
Phone
(888) 447-9056
Fax
(888) 845-0838
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Frank Bryan
Title
Adm Office MGR
Phone
(888) 447-9056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

6280 S Valley View Blvd
Suite 220
Las Vegas, NV 89118-3809

Mailing address

38 Tesla
Suite 150
Irvine, CA 92618-4670
Phone (888) 447-9056

Other names 1

  • Source One Medical Inc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Source One Medical Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6280 S Valley View Blvd
Ste 220
Las Vegas, NV 89118

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1679736888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 TESLA",
            "address_2": "SUITE 150",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184670",
            "telephone_number": "888-447-9056",
            "fax_number": "888-845-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6280 S VALLEY VIEW BLVD",
            "address_2": "SUITE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183809",
            "telephone_number": "888-447-9056",
            "fax_number": "888-845-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE ONE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "BRYAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "ADM OFFICE MGR",
        "authorized_official_telephone_number": "888-447-9056"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Source One Medical Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.