Provider Demographics
NPI:1750732236
Name:DIRECT HEALTHSOURCE, INC
Entity type:Organization
Organization Name:DIRECT HEALTHSOURCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CFO
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-529-1849
Mailing Address - Street 1:9809 101ST AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-2600
Mailing Address - Country:US
Mailing Address - Phone:718-529-1849
Mailing Address - Fax:718-529-1545
Practice Address - Street 1:9809 101ST AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2600
Practice Address - Country:US
Practice Address - Phone:718-529-1849
Practice Address - Fax:718-529-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health