Provider Demographics
NPI:1518385764
Name:EXPRESS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EXPRESS HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-943-0707
Mailing Address - Street 1:PO BOX 1982
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-1982
Mailing Address - Country:US
Mailing Address - Phone:251-943-0707
Mailing Address - Fax:251-943-0706
Practice Address - Street 1:1219 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-3552
Practice Address - Country:US
Practice Address - Phone:251-943-0707
Practice Address - Fax:251-943-0706
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXPRESS HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL788332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4347850004Medicare NSC