Provider Demographics
NPI:1396294344
Name:RADIANT EXPRESS LLC
Entity type:Organization
Organization Name:RADIANT EXPRESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-251-0885
Mailing Address - Street 1:862 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1233
Mailing Address - Country:US
Mailing Address - Phone:908-251-0885
Mailing Address - Fax:
Practice Address - Street 1:862 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1233
Practice Address - Country:US
Practice Address - Phone:908-251-0885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory