Organization
EXPRESS MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHDI NIKPARVARFARD (OWNER)
(570) 441-4267
Entity
Organization
Contact information
Practice address
2615 E COLLEGE AVE, STATE COLLEGE, PA 16801
(814) 308-8155
(814) 308-8584
Mailing address
2615 E COLLEGE AVE, STATE COLLEGE, PA 16801
(814) 308-8155
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MD424252
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010805460001
—
PA
Enumeration date
11/03/2011
Last updated
11/03/2011
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