NPI 1801628680
Main Source Medical LLC
Practice location
- Address
- 2155 E Trenton Ave, Fresno, CA 93720-3924
- Phone
- (805) 453-0191
Authorised official
- Name
- Sandra Denise Ibrahim
- Title
- Ceo
- Phone
- (800) 601-6571
Registered specialties (2)
Nursing Care Agency
Primary
In Home Supportive Care Agency
Registry record
- NPI
- 1801628680
- Entity type
- Organization
- NPI issued
- 19 Aug 2024
- Record last updated
- 19 Aug 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.