MEDICARE: JESS XPRESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1285290486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESS XPRESS, LLC

Provider Business Mailing Address
First Line	:	505 CYNTHIA DR
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75605-3743
Country	:	US
Telephone Number	:	281-865-3753
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 CYNTHIA DR
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75605-3743
Country	:	US
Telephone Number	:	281-865-3753
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	JESSICA LONG
Credential	:
Telephone Number	:	281-865-3753

Provider Enumeration Date	:	05/13/2019
Last Update Date	:	05/13/2019

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