Organization
MED SUPPLIES EXPRESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MBAUKWU U ANABA (PRESIDENT)
(678) 377-5660
Entity
Organization
Contact information
Practice address
925 CRIPPLE CREEK DR, STE 500, LAWRENCEVILLE, GA 30043-8503
(678) 377-5660
(770) 454-0123
Mailing address
925 CRIPPLE CREEK DR, STE 500, LAWRENCEVILLE, GA 30043-8503
(678) 377-5660
(770) 454-0123
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
4860980001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200813470A
—
IN
05
—
884938199A
—
GA
Enumeration date
08/31/2006
Last updated
04/11/2011
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