Provider Demographics
NPI:1346707791
Name:MED SUPPLIES EXPRESS INC
Entity Type:Organization
Organization Name:MED SUPPLIES EXPRESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MBAUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ANABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-377-5660
Mailing Address - Street 1:925 CRIPPLE CREEK DR STE 500
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8504
Mailing Address - Country:US
Mailing Address - Phone:678-377-5660
Mailing Address - Fax:770-454-0123
Practice Address - Street 1:925 CRIPPLE CREEK DR STE 500
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-8504
Practice Address - Country:US
Practice Address - Phone:678-377-5660
Practice Address - Fax:770-454-0123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED-SUPPLIES EXPRESS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty