Provider Demographics
NPI:1255502076
Name:AXPRESS MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:AXPRESS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:O
Authorized Official - Last Name:IKWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-783-1899
Mailing Address - Street 1:3933 ARROW DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4646
Mailing Address - Country:US
Mailing Address - Phone:919-783-1899
Mailing Address - Fax:919-783-2389
Practice Address - Street 1:3933 ARROW DR
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4646
Practice Address - Country:US
Practice Address - Phone:919-783-1899
Practice Address - Fax:919-783-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies