MEDICARE: EXPRESS MEDICAL EQUIPMENT, 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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1578704318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	195 PRATHER PARK DR
Second Line	:	UNIT 2
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7911
Country	:	US
Telephone Number	:	843-236-4271
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 PRATHER PARK DR
Second Line	:	UNIT 2
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7911
Country	:	US
Telephone Number	:	843-236-4271
Fax Number	:

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	JUSTIL CRUZ
Credential	:
Telephone Number	:	973-926-1400

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	08/19/2009

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