Provider Demographics
NPI:1033407051
Name:EXPRESS HOME CARE AGENCY
Entity Type:Organization
Organization Name:EXPRESS HOME CARE AGENCY
Other - Org Name:EXPRESS NURSING CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-789-1959
Mailing Address - Street 1:6495 NEW HAMPSHIRE AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3245
Mailing Address - Country:US
Mailing Address - Phone:301-789-1959
Mailing Address - Fax:301-789-1928
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE
Practice Address - Street 2:STE 110
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:301-789-1959
Practice Address - Fax:301-789-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health