Organization
EXPRESS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO MAGLONCIO DEOCAMPO (ADMINISTRATOR/MANAGING PARTNER)
(619) 423-2600
Entity
Organization
Contact information
Practice address
639 MARSAT CT, SUITE B, CHULA VISTA, CA 91911-4678
(619) 423-2600
(619) 423-2681
Mailing address
1254 LINDSAY ST, CHULA VISTA, CA 91913-1431
(619) 423-2600
(619) 423-2681
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
49252
CA
Other
Enumeration date
05/24/2006
Last updated
06/17/2009
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