Provider Demographics
NPI:1497035083
Name:EXPRESS HEALTH PHARMACY
Entity type:Organization
Organization Name:EXPRESS HEALTH PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISKANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-343-8855
Mailing Address - Street 1:EXPRESS PHARMACY HEADQUARTERS
Mailing Address - Street 2:825 CENTRAL VALLEY HWY
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263
Mailing Address - Country:US
Mailing Address - Phone:661-746-5600
Mailing Address - Fax:661-746-4978
Practice Address - Street 1:650 F ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-2018
Practice Address - Country:US
Practice Address - Phone:661-240-5900
Practice Address - Fax:661-240-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
CA507293336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2131825OtherPK