Provider Demographics
NPI:1679800841
Name:EXPRESS CARE WEST, LLC
Entity type:Organization
Organization Name:EXPRESS CARE WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NP
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:HARDIN
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:662-231-0487
Mailing Address - Street 1:PO BOX 353
Mailing Address - Street 2:
Mailing Address - City:BELDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38826-0353
Mailing Address - Country:US
Mailing Address - Phone:662-231-0487
Mailing Address - Fax:662-205-4562
Practice Address - Street 1:1651 N. COLEY RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6931
Practice Address - Country:US
Practice Address - Phone:662-269-2230
Practice Address - Fax:662-205-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care