Provider Demographics
NPI:1902951106
Name:PROSOURCE MEDCOST CONTAINMENT INC
Entity type:Organization
Organization Name:PROSOURCE MEDCOST CONTAINMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:RODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-222-2400
Mailing Address - Street 1:6021 MORRISS RD
Mailing Address - Street 2:STE 113
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3710
Mailing Address - Country:US
Mailing Address - Phone:214-222-2400
Mailing Address - Fax:214-222-2400
Practice Address - Street 1:6021 MORRISS RD
Practice Address - Street 2:STE 113
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3710
Practice Address - Country:US
Practice Address - Phone:214-222-2400
Practice Address - Fax:214-222-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0066314332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies