Source One Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SOURCE ONE MEDICAL INC

Practice address

2124 S 156TH Cir
Omaha, NE 68130-2503

Phone

(888) 447-9056

Fax

(949) 387-6371

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Dennis Kline

Title

President/Ceo

Phone

(888) 447-9056

Specialties & licenses 1

Addresses

Other names 1

• Source One Medical Inc Doing business as

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1881703684",
    "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": "926184669",
            "telephone_number": "888-447-9056",
            "fax_number": "949-387-6371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 S 156TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302503",
            "telephone_number": "888-447-9056",
            "fax_number": "949-387-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE ONE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "888-447-9056"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Source One Medical Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Omaha, NE
• Providers in Omaha, NE by specialty
• Durable Medical Equipment & Medical Supplies in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.