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NPI 1407567274

NPI 1407567274 : EXPRESS 8 LLC : ATWATER, CA

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General NPI Number Information
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    NPI Number           |    1407567274
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    Entity Type          |    Organization 
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    Legal Business Name  |    EXPRESS 8 LLC 
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Dates
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    Enumeration Date     |    12/12/2022
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    Last Update Date     |    12/12/2022
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Provider Practice Location Address
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    Address Line         |    521 BELLEVUE RD 
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    City                 |    ATWATER
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    State                |    CA
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    Zip                  |    95301-2928
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    Country              |    US
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    Telephone            |    209-947-4481
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    521 BELLEVUE RD 
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    City                 |    ATWATER
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    State                |    CA
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    Zip                  |    95301-2928
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MEMBER
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    Name                 |    MR. MANUEL  CARRANZA 
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    Credential           |    
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    Telephone            |    120-994-7448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    
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    License Number State |    
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