Organization
EXPEDIA MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUETTE DIAMOND LAND GINYARD (PRESIDENT)
(704) 236-9895
Entity
Organization
Contact information
Practice address
4416 MONROE RD STE E, CHARLOTTE, NC 28205-7761
(704) 236-9895
Mailing address
4416 MONROE RD STE E, CHARLOTTE, NC 28205-7761
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
01/30/2012
Last updated
02/17/2012
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