Provider Demographics
NPI:1629344288
Name:CENTRAL EXPRESS CLINIC PLLC
Entity Type:Organization
Organization Name:CENTRAL EXPRESS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:9895-161-4317
Mailing Address - Street 1:306 W BROOMFIELD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4515
Mailing Address - Country:US
Mailing Address - Phone:989-772-2100
Mailing Address - Fax:989-772-2103
Practice Address - Street 1:611 COURT ST
Practice Address - Street 2:STE. A
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9390
Practice Address - Country:US
Practice Address - Phone:989-516-4317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty