# SIERRA EXPRESS MEDICAL DELIVERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SIEMEDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396437265
- **Authorized official:** MR. EMMANUEL JOSEPH KEH YILLAH BA,MA (CEO)
- **Authorized official phone:** (571) 477-6774

## Contact information

- **Practice address:** 57 TUPELO ST, BROCKTON, MA 02301-5654
- **Practice address phone:** (857) 777-8704
- **Mailing address:** 57 TUPELO ST, BROCKTON, MA 02301-5654
- **Mailing address phone:** (857) 777-8704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YP1600X | Pastoral Counselor | — | NULL | — |
| 101YP1600X | Pastoral Counselor | — | — | — |
| 171W00000X | Contractor | — | NULL | — |
| 171W00000X | Contractor | — | — | — |
| 171WV0202X | Vehicle Modifications Contractor | — | NULL | — |
| 171WV0202X | Vehicle Modifications Contractor | — | — | — |
| 347E00000X | Transportation Broker | — | NULL | Yes |

## Other

- **Enumeration date:** 05/22/2023
- **Last updated:** 05/22/2023