Provider Demographics
NPI:1740600733
Name:CDS EXPRESS LLC
Entity Type:Organization
Organization Name:CDS EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCOLLUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-727-0453
Mailing Address - Street 1:3641 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-5437
Mailing Address - Country:US
Mailing Address - Phone:314-727-0453
Mailing Address - Fax:314-727-6067
Practice Address - Street 1:3641 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-5437
Practice Address - Country:US
Practice Address - Phone:314-727-0453
Practice Address - Fax:314-727-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care