Provider Demographics
NPI:1457364762
Name:EXPRESS MEDICAL & HOSP SUPPLIES INC
Entity Type:Organization
Organization Name:EXPRESS MEDICAL & HOSP SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONDE ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-787-3621
Mailing Address - Street 1:PO BOX 2817
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960
Mailing Address - Country:US
Mailing Address - Phone:787-787-3621
Mailing Address - Fax:787-787-4280
Practice Address - Street 1:AVE CARLOS J ANDALUZ NOGAL 3D-31
Practice Address - Street 2:LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-787-3621
Practice Address - Fax:787-787-4280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR54767OtherTRIPLE S
PR9000375OtherLA CRUZ AZUL DE PR
PR0338570001Medicare NSC