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General NPI Number Information
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NPI Number | 1295856896
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Entity Type | Organization
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Legal Business Name | EXPRESSMED, LLC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1 HIGHLANDER WAY SUITE 2
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City | MANCHESTER
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State | NH
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Zip | 03103-7403
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Country | US
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Telephone | 603-625-2622
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Fax | 603-626-1816
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Provider Business Mailing Address
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Address Line | 1 HIGHLANDER WAY
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City | MANCHESTER
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State | NH
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Zip | 03103-7403
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Country | US
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Telephone | 603-625-2622
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Fax | 603-626-1816
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | ROBIN C OSTERGARD
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Credential |
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Telephone | 603-506-6833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 7412
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 03866
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License Number State | NH
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