Organization
EXPRESS CARE MEDICAL SUPPLY INC
Active
Organization
EXPRESS CARE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA I ILYASOV (PRESIDENT)
(248) 968-2999
Entity
Organization
Contact information
Practice address
25900 GREENFIELD RD, # 121, OAK PARK, MI 48237-1292
(248) 968-2999
(248) 968-9699
Mailing address
25900 GREENFIELD RD, # 121, OAK PARK, MI 48237-1292
(248) 968-2999
(248) 968-9699
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145043
PPOM
MI
01
—
540F322010
BCBS
MI
05
—
874585890
—
MI
Enumeration date
07/12/2005
Last updated
11/12/2013
Update your record
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