| Express Family Care, Llc | |
|
3960 Valley Gateway Blvd Suite 1-a Roanoke VA 24012-6858 | |
| (540) 904-3169 | |
| Not Available |
| Full Name | Express Family Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3960 Valley Gateway Blvd, Roanoke, Virginia |
| Authorized Official Name and Position | David Alligood (OWNER) |
| Authorized Official Contact | 5404006676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Family Care, Llc 3960 Valley Gateway Blvd Suite 1-a Roanoke VA 24012-6858 Ph: (540) 904-3169 | Express Family Care, Llc 3960 Valley Gateway Blvd Suite 1-a Roanoke VA 24012-6858 Ph: (540) 904-3169 |
| NPI Number | 1710315825 |
|---|---|
| Provider Enumeration Date | 10/29/2013 |
| Last Update Date | 02/07/2023 |
| Medicare PECOS PAC ID | 2668600909 |
|---|---|
| Medicare Enrollment ID | O20140114000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710315825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Douglas S Hayes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528040060 PECOS PAC ID: 5597668566 Enrollment ID: I20040128000500 |
| Provider Name | Mary Deborah Leatherland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528056355 PECOS PAC ID: 2668437633 Enrollment ID: I20071213000721 |
| Provider Name | Scott James Crosby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699816975 PECOS PAC ID: 3375618184 Enrollment ID: I20080813000482 |
| Provider Name | David B Alligood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447353768 PECOS PAC ID: 4789741554 Enrollment ID: I20090323000156 |
| Provider Name | Ryan J Mclennan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609133958 PECOS PAC ID: 5799096095 Enrollment ID: I20150831001788 |
| Provider Name | Christopher C Deramo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659975910 PECOS PAC ID: 6709292246 Enrollment ID: I20210309001192 |
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