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General NPI Number Information
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NPI Number | 1619088796
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Entity Type | Organization
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Legal Business Name | MED SUPPLIES EXPRESS INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 925 CRIPPLE CREEK DR STE 500
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8503
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Country | US
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Telephone | 678-377-5660
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Fax | 770-454-0123
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Provider Business Mailing Address
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Address Line | 925 CRIPPLE CREEK DR STE 500
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8503
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Country | US
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Telephone | 678-377-5660
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Fax | 770-454-0123
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MBAUKWU U ANABA
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Credential |
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Telephone | 678-377-5660
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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 | 4860980001
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License Number State | GA
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