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General NPI Number Information
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NPI Number | 1063608529
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Entity Type | Organization
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Legal Business Name | EXPRESS DURABLE MEDICAL EQUIPMENT,INC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 512 VICTORIA LN STE 10B
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City | HARLINGEN
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State | TX
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Zip | 78550-3230
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Country | US
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Telephone | 956-440-8100
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Fax | 956-440-8490
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Provider Business Mailing Address
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Address Line | 512 VICTORIA LN SUITE 10-B
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City | HARLINGEN
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State | TX
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Zip | 78550-3226
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Country | US
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Telephone | 956-440-8100
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Fax | 956-440-8490
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN TREVINO
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Credential |
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Telephone | 956-440-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 423098
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License Number State | TX
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