Healthcare Provider Details

I. General information

NPI: 1972490548
Provider Name (Legal Business Name): MED ONE EXPRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W OAK LN STE B
GLENOLDEN PA
19036-1228
US

IV. Provider business mailing address

53 TOMASELLO DR
MILLVILLE NJ
08332-9424
US

V. Phone/Fax

Practice location:
  • Phone: 610-583-5006
  • Fax:
Mailing address:
  • Phone: 610-983-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHENEQUA SMITH
Title or Position: OWNER
Credential:
Phone: 610-983-5006