Provider Demographics
NPI:1174205330
Name:EXPRESS CARE TRANSPORT LLC
Entity type:Organization
Organization Name:EXPRESS CARE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:LEMANT
Authorized Official - Last Name:GATLING
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:919-695-6287
Mailing Address - Street 1:10700 NELSON RIDGE CT APT 12
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4875
Mailing Address - Country:US
Mailing Address - Phone:919-695-6287
Mailing Address - Fax:
Practice Address - Street 1:10700 NELSON RIDGE CT APT 12
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4875
Practice Address - Country:US
Practice Address - Phone:919-695-6287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)