| Primary Express LLC | |
|
209 Cleveland Ave Ste A Martinsville VA 24112-3714 | |
| (276) 252-4200 | |
| Not Available |
| Full Name | Primary Express LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 209 Cleveland Ave Ste A, Martinsville, Virginia |
| Authorized Official Name and Position | Cody V Williams (MANAGING MEMBER) |
| Authorized Official Contact | 2762524200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Express LLC 209 Cleveland Ave Ste A Martinsville VA 24112-3714 | Primary Express LLC 209 Cleveland Ave Ste A Martinsville VA 24112-3714 Ph: (276) 252-4200 |
| NPI Number | 1740144617 |
|---|---|
| Provider Enumeration Date | 12/15/2025 |
| Last Update Date | 12/23/2025 |
| Certification Date | 12/23/2025 |
| Medicare PECOS PAC ID | 3971073289 |
|---|---|
| Medicare Enrollment ID | O20260528001486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740144617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | Tara Renee Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235779646 PECOS PAC ID: 9830527423 Enrollment ID: I20211210002242 |
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