MEDICARE: HEALTH EXPRESS, 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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1295193654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH EXPRESS, LLC

Provider Business Mailing Address
First Line	:	77 SPRING ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-4302
Country	:	US
Telephone Number	:	781-626-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 SPRING ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-4302
Country	:	US
Telephone Number	:	781-626-5600
Fax Number	:

Authorized Official
Title or Position	:	MD/CEO
Name	:	CHRISTOPHER WHELAN
Credential	:	MD
Telephone Number	:	781-626-5160

Provider Enumeration Date	:	02/01/2016
Last Update Date	:	10/18/2016

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