Provider Demographics
NPI:1629652110
Name:HEATH SOURCE THERAPY SUPPLIES LLC
Entity Type:Organization
Organization Name:HEATH SOURCE THERAPY SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:TONUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-224-8317
Mailing Address - Street 1:2001 PALM BEACH LAKES BLVD STE 502P
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6510
Mailing Address - Country:US
Mailing Address - Phone:203-224-8317
Mailing Address - Fax:
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD STE 502P
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6510
Practice Address - Country:US
Practice Address - Phone:203-224-8317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies