MEDICARE: EXPRESSCARE MEDICAL SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	5-02121	KS

General Provider Information

NPI Number	:	1023115169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESSCARE MEDICAL SERVICES, INC

Provider Business Mailing Address
First Line	:	5019 LEAVENWORTH RD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104-2256
Country	:	US
Telephone Number	:	913-789-9573
Fax Number	:	913-789-9268

Provider Business Practice Location Address
First Line	:	5019 LEAVENWORTH RD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104-2256
Country	:	US
Telephone Number	:	913-789-9573
Fax Number	:	913-789-9268

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	ROBERT OKOROH WMKPAH
Credential	:	BSN
Telephone Number	:	913-789-9573

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/11/2008

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