Provider Demographics
NPI:1568150654
Name:EXPRESS SUPPLY 8 INC
Entity Type:Organization
Organization Name:EXPRESS SUPPLY 8 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-848-0338
Mailing Address - Street 1:5919 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2717
Mailing Address - Country:US
Mailing Address - Phone:347-848-0338
Mailing Address - Fax:347-848-0135
Practice Address - Street 1:5919 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2717
Practice Address - Country:US
Practice Address - Phone:347-848-0338
Practice Address - Fax:347-848-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies