Provider Demographics
NPI:1073600615
Name:EXPRESSCARE SUPPLY SERVICES, INC.
Entity type:Organization
Organization Name:EXPRESSCARE SUPPLY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LORA-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-466-2929
Mailing Address - Street 1:21002 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1132
Mailing Address - Country:US
Mailing Address - Phone:305-466-7979
Mailing Address - Fax:305-466-2929
Practice Address - Street 1:21002 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1132
Practice Address - Country:US
Practice Address - Phone:305-466-7979
Practice Address - Fax:305-466-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies