Organization Name: | EXPRESS MEDICAL SUPPLY |
NPI Number: | 1003861329 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDUARDO MAGLONCIO DEOCAMPO (ADMINISTRATOR/MANAGING PARTNER) |
Mailing Address: | 639 Marsat Ct Suite B Chula Vista |
State: | CA US |
Postal Code: | 919114678 |
Phone Number: | 6194232600 |
Fax Number: | 6194232681 |
NPI Enumeration Date: | 05/24/2006 |
NPI Last Update Date: | 06/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 49252 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |