Organization
EXPRESS CARE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RITA ILYASOV (PRESIDENT)
(248) 451-0073
Entity
Organization
Contact information
Practice address
12 W HURON ST, PONTIAC, MI 48342-2100
(248) 451-0073
(248) 451-0082
Mailing address
12 W HURON ST, PONTIAC, MI 48342-2100
(248) 451-0073
(248) 451-0082
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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