Provider Demographics
NPI:1548512197
Name:SLUMBERSOURCE, LLC
Entity type:Organization
Organization Name:SLUMBERSOURCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:EHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-431-4066
Mailing Address - Street 1:789 N GROVE RD
Mailing Address - Street 2:STE. 115
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6208
Mailing Address - Country:US
Mailing Address - Phone:214-431-4060
Mailing Address - Fax:
Practice Address - Street 1:789 N GROVE RD
Practice Address - Street 2:STE. 115
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6208
Practice Address - Country:US
Practice Address - Phone:214-431-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-06
Last Update Date:2012-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies