Provider Demographics
NPI:1366838591
Name:EXPRESS CARE OF HOBBS
Entity Type:Organization
Organization Name:EXPRESS CARE OF HOBBS
Other - Org Name:SEMINOLE EXPRESS CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MBA
Authorized Official - Phone:432-758-6015
Mailing Address - Street 1:3900 N LOVINGTON HWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1160
Mailing Address - Country:US
Mailing Address - Phone:432-758-6015
Mailing Address - Fax:432-758-6016
Practice Address - Street 1:3900 N LOVINGTON HWY
Practice Address - Street 2:SUITE 550
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1160
Practice Address - Country:US
Practice Address - Phone:432-758-6015
Practice Address - Fax:432-758-6016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6105261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF53024Medicare UPIN