Express Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EXPRESS MEDICAL SUPPLY

Practice address

6521 Arlington Blvd
Suite#205
Falls Church, VA 22042-3009

Phone

(703) 533-7585

Fax

(866) 866-3534

NPI assigned

Jun 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jebessa Alemayehu Daba

Title

Ceo/Owner

Phone

(703) 346-8796

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1114123890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6521 ARLINGTON BLVD",
            "address_2": "SUITE#205",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423009",
            "telephone_number": "703-533-7585",
            "fax_number": "866-866-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6521 ARLINGTON BLVD",
            "address_2": "SUITE#205",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220423009",
            "telephone_number": "703-533-7585",
            "fax_number": "866-866-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "DABA",
        "authorized_official_first_name": "JEBESSA",
        "authorized_official_middle_name": "ALEMAYEHU",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "703-346-8796",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114123890",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0392253 00",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018559100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.