PERFUSION SOURCE LTD
Transportation at East End Ave, Chicago, IL

License number
Illinois 6519 MC
Category
Transportation
Type
Non-emergency Medical Transport (VAN)
Owner
Name: MR. BERNARD WASHINGTON CCP
Title: PRESIDENT
Phone: (773) 731-7373
Address
Address
7725 EAST East End Ave, Chicago, IL 60649
National Provider ID: 1629242987
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PERFUSION SOURCE,LTD

Chicago, IL 60649

Status:
Inactive
Registration:
Apr 9, 1993
State ID:
57264535
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Bernard Washington,7725 S East End, Chicago, IL 60649 (Physical)

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