EXPRESSMED LLC NPI 1407385602

NPI Information

NPI: 1407385602
Provider Name: EXPRESSMED, LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 30D2134221

Address:
39 KOSCIUSZKO ST
MANCHESTER, NH
ZIP 03101
Phone: (603) 627-8053
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EXPRESSMED, LLC is an urgent care clinic center in Manchester, NH. EXPRESSMED, LLC NPI is 1407385602. The provider is registered as an organization entity type.

The provider's business location address is:

39 KOSCIUSZKO ST
MANCHESTER, NH
ZIP 03101-608
Phone: (603) 627-8053
Fax: (603) 627-4241

The provider's authorized official is Nicholas James Vailas .
The authorized official title is Ceo and has the following contact phone number (603) 625-2622.

The CLIA number assigned to this NPI record is 30D2134221 - other - wic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2017 and was last updated on 6/9/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care	04212	NEW HAMPSHIRE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3100771	MEDICAID	NEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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