Organization Active NPI

Express Care Medical Supply Inc

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, MI
National Provider Identifier
1821395229
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
EXPRESS CARE MEDICAL SUPPLY INC
Practice address
12 W Huron St
Pontiac, MI 48342-2100
Phone
(248) 451-0073
NPI assigned
Feb 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Mrs. Rita Ilyasov
Title
President
Phone
(248) 451-0073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

12 W Huron St
Pontiac, MI 48342-2100

Mailing address

12 W Huron St
Pontiac, MI 48342-2100
Phone (248) 451-0073

Other identifiers 1

IdentifierTypeStateIssuer
6612000001OtherMIMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

25900 Greenfield Rd
Ste 121
Oak Park, MI 48237
Phone (248) 968-2999

NPI Registry JSON

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1821395229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422100",
            "telephone_number": "248-451-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422100",
            "telephone_number": "248-451-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CARE MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "ILYASOV",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-451-0073",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "6612000001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.