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NPI Code Detail

MEDICARE: DALLAH EXPRESS LLC

MEDICARE: DALLAH 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
1163WA2000XAdministrator Registered Nurse
2163WC0400XCase Management Registered Nurse
3163WG0000XGeneral Practice Registered Nurse
4163WH0200XHome Health Registered Nurse
5163WH1000XHospice Registered Nurse
6163WW0000XWound Care Registered Nurse
7164W00000XLicensed Practical Nurse
8171W00000XContractor
9172A00000XDriver
10208D00000XGeneral Practice Physician
11363LP0200XPediatric Nurse Practitioner
12372600000XAdult Companion
13374U00000XHome Health Aide
14376K00000XNurse's Aide
15163W00000XRegistered Nurse

General Provider Information

NPI Number : 1720910938
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAH EXPRESS LLC
Provider Business Mailing Address
First Line : 1869 SUNSET DR
Second Line :
City : WHITEHALL
State : PA
Zip : 18052-4127
Country : US
Telephone Number : 201-985-4887
Fax Number :
Provider Business Practice Location Address
First Line : 1869 SUNSET DR
Second Line :
City : WHITEHALL
State : PA
Zip : 18052-4127
Country : US
Telephone Number : 201-985-4887
Fax Number :
Authorized Official
Title or Position : C.E.O
Name : BERYL MATENGO
Credential :
Telephone Number : 201-985-4887
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “DALLAH EXPRESS LLC ” Practice Location

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