Organization
EXPRESS MEDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIDEOFOR N DALLAH (PRESIDENT)
(248) 233-6511
Entity
Organization
Contact information
Practice address
28350 GRATIOT AVENUE, ROSEVILLE, MI 48066
(866) 561-3018
(586) 776-2634
Mailing address
19785 WEST TWELVE MILE ROAD, SUITE 488, SOUTHFIELD, MI 48076
(248) 233-6511
(248) 233-6512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
5301008495
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4941172
—
MI
Enumeration date
10/02/2006
Last updated
03/27/2008
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