Provider Demographics
NPI:1114493277
Name:EXPRESS ENTERPRISE
Entity Type:Organization
Organization Name:EXPRESS ENTERPRISE
Other - Org Name:EXPRESS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILKENSCOL
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:732-867-4418
Mailing Address - Street 1:248 REYNOLDS TER APT 3A
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-3341
Mailing Address - Country:US
Mailing Address - Phone:732-867-4418
Mailing Address - Fax:
Practice Address - Street 1:134 EVERGREEN PL STE 805
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2017
Practice Address - Country:US
Practice Address - Phone:732-867-4418
Practice Address - Fax:877-215-8914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty