1285631143 NPI number — APEX MOBILITY PRODUCTS, LLC

Table of content: (NPI 1285631143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285631143 NPI number — APEX MOBILITY PRODUCTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APEX MOBILITY PRODUCTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285631143
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 777
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERSAILLES
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40383-0777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-873-5049
Provider Business Mailing Address Fax Number:
859-873-1226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
304 CROSSFIELD DR STE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERSAILLES
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40383-1597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-873-5049
Provider Business Practice Location Address Fax Number:
859-873-1226
Provider Enumeration Date:
07/06/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
RODDY
Authorized Official Middle Name:
FORD
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
859-873-5049

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000318034 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 90006198 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".