Organization
EXPRESS MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO MAGLONCIO DEOCAMPO (PRESIDENT)
(702) 656-8312
Entity
Organization
Contact information
Practice address
3065 N RANCHO DR, SUITE 152, LAS VEGAS, NV 89130-3352
(702) 656-8312
(702) 656-1579
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
MP00551
NV
Other
Enumeration date
08/20/2008
Last updated
06/18/2009
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