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General NPI Number Information
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NPI Number | 1518059450
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Entity Type | Organization
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Legal Business Name | XPRESS DURABLE MEDICAL EQUIPMENTS AND SUPPLIES
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 6048 OGONTZ AVE FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1347
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Country | US
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Telephone | 215-924-3006
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Fax | 215-924-3008
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Provider Business Mailing Address
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Address Line | 6048 OGONTZ AVE FL 1
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1347
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Country | US
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Telephone | 215-924-3006
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Fax | 215-924-3008
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Authorized Official
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Title or Position | OWNER
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Name | MR. EMMANUEL EGBUNA NWOBODO
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Credential |
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Telephone | 215-924-3006
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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 | 3659669
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License Number State | PA
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