NPI 1881612794

Medsource Dme, INC

Organisation Durable Medical Equipment & Medical Supplies Blytheville, AR

Practice location

Address: 615 W Moultrie Dr, Blytheville, AR 72315-1936
Phone: (870) 780-6111
Fax: (870) 762-0900

Authorised official

Name: James Ernest Stevenson
Title: Owner/President
Phone: (870) 780-6111

Registered specialties

Durable Medical Equipment & Medical Supplies Primary

Suppliers Taxonomy 332B00000X Licence 000614 (AR)

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Registry record

NPI: 1881612794
Entity type: Organization
NPI issued: 18 Jul 2006
Record last updated: 22 Aug 2020

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.