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Contact Information

ORTHO EXPRESS HOLDING COMPANY, LLC
608 W CHURCH ST
BOONEVILLE, MS38829
 Phone: 662-534-2227
 Fax: 662-534-2330
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Medical Specialty

261QM2500X
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ORTHO EXPRESS HOLDING COMPANY, LLC

NPI # 1962029249
LBN Legal business name ORTHO EXPRESS HOLDING COMPANY, LLC
Authorized official JENNIFER BULLOCK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/02/2020
Last updated 09/10/2025 - About 9 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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