Provider Demographics
NPI:1639367113
Name:EXPRESS MEDICAL STAFFING, INC.
Entity Type:Organization
Organization Name:EXPRESS MEDICAL STAFFING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISCOE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-649-3565
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:LA
Mailing Address - Zip Code:71435-0388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8517 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-4324
Practice Address - Country:US
Practice Address - Phone:318-649-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA 140203747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty