Provider Demographics
NPI:1710315825
Name:EXPRESS FAMILY CARE, LLC
Entity Type:Organization
Organization Name:EXPRESS FAMILY CARE, LLC
Other - Org Name:EXPRESS FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLIGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-400-6676
Mailing Address - Street 1:3960 VALLEY GATEWAY BLVD
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-6858
Mailing Address - Country:US
Mailing Address - Phone:540-904-3169
Mailing Address - Fax:
Practice Address - Street 1:3960 VALLEY GATEWAY BLVD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-6858
Practice Address - Country:US
Practice Address - Phone:540-904-3169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care