NPIMap

Organization Active NPI

Primesource Healthcare Systems, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Columbus, OH
National Provider Identifier
1801008644
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PRIMESOURCE HEALTHCARE SYSTEMS, INC.
Practice address
4449 Easton Way
Second Floor
Columbus, OH 43219-6093
Phone
(800) 317-0711
Fax
(847) 267-9440
NPI assigned
May 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David Fleming
Title
President & Ceo
Phone
(847) 580-5928

Specialties & licenses 1

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

Addresses

Primary practice location

4449 Easton Way
Second Floor
Columbus, OH 43219-6093

Mailing address

775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342
Phone (847) 580-5928

Other identifiers 1

IdentifierTypeStateIssuer
0579450001OtherDMERC GROUP NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801008644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154342",
            "telephone_number": "847-580-5928",
            "fax_number": "847-267-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4449 EASTON WAY",
            "address_2": "SECOND FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432196093",
            "telephone_number": "800-317-0711",
            "fax_number": "847-267-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMESOURCE HEALTHCARE SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "847-580-5928",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC GROUP NUMBER",
            "identifier": "0579450001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.