Provider Demographics
NPI:1609876267
Name:EXPRESS MEDICAL PRODUCTS, INC.
Entity Type:Organization
Organization Name:EXPRESS MEDICAL PRODUCTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:O
Authorized Official - Last Name:QUIRK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-664-2303
Mailing Address - Street 1:910 PIERREMONT ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2058
Mailing Address - Country:US
Mailing Address - Phone:318-424-4150
Mailing Address - Fax:318-424-4181
Practice Address - Street 1:301 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4722
Practice Address - Country:US
Practice Address - Phone:225-664-2303
Practice Address - Fax:225-665-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1386065Medicaid
LA1386065Medicaid