Provider Demographics
NPI:1215185996
Name:EXPRESS MED OF ALABAMA LLC
Entity Type:Organization
Organization Name:EXPRESS MED OF ALABAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-760-1655
Mailing Address - Street 1:970 COX CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633-1631
Mailing Address - Country:US
Mailing Address - Phone:256-760-1655
Mailing Address - Fax:256-760-1699
Practice Address - Street 1:970 COX CREEK PKWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35633-1631
Practice Address - Country:US
Practice Address - Phone:256-760-1655
Practice Address - Fax:256-760-1699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty