One Source Medical Supply Group

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ONE SOURCE MEDICAL SUPPLY GROUP

Practice address

13447 166TH PL
Suite 4G
Jamaica, NY 11434-3853

Phone

(718) 880-0437

NPI assigned

Sep 10, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Leshun I Faye

Title

Owner

Phone

(718) 880-0437

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1952736977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13447 166TH PL",
            "address_2": "SUITE 4G",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343853",
            "telephone_number": "718-880-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13447 166TH PL",
            "address_2": "SUITE 4G",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114343853",
            "telephone_number": "718-880-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE SOURCE MEDICAL SUPPLY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "FAYE",
        "authorized_official_first_name": "LESHUN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-880-0437",
        "authorized_official_name_prefix": "Mrs."
    },
    "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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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.