Provider Demographics
NPI:1780153668
Name:EXPRESS TOX LLC
Entity type:Organization
Organization Name:EXPRESS TOX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPREASENTIVE
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-660-2111
Mailing Address - Street 1:4601 N CONGRESS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3381
Mailing Address - Country:US
Mailing Address - Phone:561-814-5846
Mailing Address - Fax:561-469-8769
Practice Address - Street 1:4601 N CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3381
Practice Address - Country:US
Practice Address - Phone:561-814-5846
Practice Address - Fax:561-469-8769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory