Healthcare Provider Details
I. General information
NPI: 1679270961
Provider Name (Legal Business Name): XPRESS MEDICAL TRANSPORT II LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4433 AIRPORT RD
PINEHURST NC
28374-8993
US
IV. Provider business mailing address
4433 AIRPORT RD
PINEHURST NC
28374-8993
US
V. Phone/Fax
- Phone: 910-651-6773
- Fax:
- Phone: 910-651-6773
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MICHAEL
ROUSE
Title or Position: OWNER /PRESIDENT
Credential:
Phone: 910-651-6773