Healthcare Provider Details

I. General information

NPI: 1609876267
Provider Name (Legal Business Name): EXPRESS MEDICAL PRODUCTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 VETERANS BLVD
DENHAM SPRINGS LA
70726-4722
US

IV. Provider business mailing address

910 PIERREMONT ROAD SUITE 108
SHREVEPORT LA
71106-2058
US

V. Phone/Fax

Practice location:
  • Phone: 225-664-2303
  • Fax: 225-665-0510
Mailing address:
  • Phone: 318-424-4150
  • Fax: 318-424-4181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. GENE O QUIRK JR.
Title or Position: OWNER
Credential:
Phone: 225-664-2303