1205340494 NPI number — HEALTH EXPRESS URGENT CARE PLLC

Table of content: (NPI 1205340494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205340494 NPI number — HEALTH EXPRESS URGENT CARE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTH EXPRESS URGENT CARE PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205340494
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
94 DOG PATCH TRADING CENTER
Provider Second Line Business Mailing Address:
SUITE-2
Provider Business Mailing Address City Name:
LONDON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40741-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-877-1352
Provider Business Mailing Address Fax Number:
606-877-1356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
94 DOG PATCH TRADING CENTER
Provider Second Line Business Practice Location Address:
SUITE-2
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40741-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-877-1352
Provider Business Practice Location Address Fax Number:
606-877-1356
Provider Enumeration Date:
11/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
YUMANG
Authorized Official First Name:
EMMANUEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT OWNER
Authorized Official Telephone Number:
606-887-1352

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QU0200X , with the licence number: 1000633 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com