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General NPI Number Information
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NPI Number | 1801830567
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Entity Type | Organization
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Legal Business Name | EXPRESS MEDICAL SUPPLY, LTD.
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 803 US HIGHWAY 83 N
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City | CHILDRESS
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State | TX
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Zip | 79201
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Country | US
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Telephone | 940-937-3370
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Fax | 940-937-3735
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Provider Business Mailing Address
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Address Line | 220 W GERMANTOWN PIKE STE 250
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | WENDY RUSSALESI
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Credential |
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Telephone | 484-246-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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