Provider Demographics
NPI:1619602224
Name:EXPRESS HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:EXPRESS HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-708-4106
Mailing Address - Street 1:915 N 48TH AVE APT TH915N48
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-4305
Mailing Address - Country:US
Mailing Address - Phone:402-708-4106
Mailing Address - Fax:
Practice Address - Street 1:915 N 48TH AVE APT 915N48TH
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-4305
Practice Address - Country:US
Practice Address - Phone:402-708-4106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty