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General NPI Number Information
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NPI Number | 1740144617
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Entity Type | Organization
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Legal Business Name | PRIMARY EXPRESS LLC
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 209 CLEVELAND AVE STE A
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3714
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Country | US
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Telephone | 276-252-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 209 CLEVELAND AVE STE A
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3714
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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 | MANAGING MEMBER
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Name | MR. CODY V WILLIAMS JR.
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Credential |
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Telephone | 276-252-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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