Provider Demographics
NPI:1316083868
Name:EXPRESS MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:EXPRESS MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEESHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-733-9500
Mailing Address - Street 1:1210 SOUTER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2837
Mailing Address - Country:US
Mailing Address - Phone:248-733-9500
Mailing Address - Fax:248-733-9400
Practice Address - Street 1:1210 SOUTER DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083
Practice Address - Country:US
Practice Address - Phone:248-733-9500
Practice Address - Fax:248-733-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X
MI5306003636332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1316083868OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI1316083868OtherAETNA
MI1316083868Medicaid