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Medisource Home Medical
Oxygen Equipment & Supplies (DME) in Kennesaw, Georgia
NPI 1770501736

Medisource Home Medical is a Oxygen Equipment & Supplies (DME) based in Kennesaw, GA and is specialized in Oxygen Equipment & Supplies. Medisource Home Medical practices in Kennesaw, GA. The NPI Number for Medisource Home Medical is 1770501736 and holds a License No. (Georgia).

The current practice location address for Medisource Home Medical is 975 Cobb Place Blvd Nw Ste 113, Kennesaw, GA and can be reached out via phone at 770-528-9559 and via fax at 770-528-9309.

Location: 975 Cobb Place Blvd Nw Ste 113, Kennesaw, GA, 30144-6848
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1770501736
Provider Name
Medisource Home Medical
Credential
Provider Entity Type
Organization
Address
975 Cobb Place Blvd Nw Ste 113, Kennesaw, GA, 30144-6848
Phone Number
770-528-9559
Fax Number
770-528-9309
Provider Enumeration Date
07/18/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
52164995 01 GA BCBS
341310291A 05 GA
1023735 01 GA UHC
institution
Provider Business Practice Location Address Details
Address
975 Cobb Place Blvd Nw Ste 113
City
Kennesaw
State
Georgia
Zip
30144-6848
Phone Number
770-528-9559
Fax Number
770-528-9309
person
Provider Business Mailing Address Details
Address
975 Cobb Place Blvd Nw Ste 113
City
Kennesaw
State
Georgia
Zip
30144-6848
Phone Number
770-528-9559
Fax Number
770-528-9309
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
()
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Oxygen Equipment & Supplies
Taxonomy
332BX2000X
License No.
()
Definition
Definition to come...
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