Provider Demographics
NPI:1275706467
Name:HEALTH EXPRESS CENTER LLC
Entity Type:Organization
Organization Name:HEALTH EXPRESS CENTER LLC
Other - Org Name:HEALTH EXPRESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-616-1905
Mailing Address - Street 1:1320 E PEBBLE RD
Mailing Address - Street 2:#100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3105
Mailing Address - Country:US
Mailing Address - Phone:702-616-1905
Mailing Address - Fax:702-616-1995
Practice Address - Street 1:1320 E PEBBLE RD
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3105
Practice Address - Country:US
Practice Address - Phone:702-616-1905
Practice Address - Fax:702-616-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty