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NPI Code Detail

MEDICARE: EXPRESS MEDICAL & NUTRITION SUPPLY INC.

MEDICARE: EXPRESS MEDICAL & NUTRITION SUPPLY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies3980120428317FL
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)3980120428317FL

General Provider Information

NPI Number : 1891722898
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXPRESS MEDICAL & NUTRITION SUPPLY INC.
Provider Business Mailing Address
First Line : 6201 JOHNS RD
Second Line : SUITE 4
City : TAMPA
State : FL
Zip : 33534
Country : US
Telephone Number : 813-885-3444
Fax Number : 813-885-1729
Provider Business Practice Location Address
First Line : 6201 JOHNS RD
Second Line : SUITE 4
City : TAMPA
State : FL
Zip : 33634-4434
Country : US
Telephone Number : 813-885-3444
Fax Number : 813-885-1729
Authorized Official
Title or Position : OWNER
Name : MR. JACK PICKENS
Credential :
Telephone Number : 813-885-3444
Provider Enumeration Date : 06/26/2006
Last Update Date : 09/11/2025

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