Provider Demographics
NPI:1083961908
Name:MSJ CONSULTING LLC
Entity Type:Organization
Organization Name:MSJ CONSULTING LLC
Other - Org Name:SOURCE ORTHOPEDIC SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-425-3209
Mailing Address - Street 1:1121 PARK WEST BLVD
Mailing Address - Street 2:SUITE B#215
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7122
Mailing Address - Country:US
Mailing Address - Phone:866-425-3209
Mailing Address - Fax:866-425-3209
Practice Address - Street 1:2612 LARCH LN
Practice Address - Street 2:SUITE 101
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7192
Practice Address - Country:US
Practice Address - Phone:866-425-3209
Practice Address - Fax:866-425-3209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies