Provider Demographics
NPI:1427029867
Name:EXPRESS HEALTHCARE INC
Entity type:Organization
Organization Name:EXPRESS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-990-9119
Mailing Address - Street 1:PO BOX 1982
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533
Mailing Address - Country:US
Mailing Address - Phone:251-990-9119
Mailing Address - Fax:251-990-3599
Practice Address - Street 1:34 N PINE ST
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-3202
Practice Address - Country:US
Practice Address - Phone:251-937-9162
Practice Address - Fax:251-937-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009987600Medicaid
AL4347850002Medicare ID - Type Unspecified