1235212739 NPI number — APEX MEDICAL SERVICES, INC

Table of content: CHERYL MAE MARTIN M.ED.,IECE (NPI 1194928259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235212739 NPI number — APEX MEDICAL SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APEX MEDICAL SERVICES, INC
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:
1235212739
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1811 GOLDEN MILE HWY
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15239-2827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-519-2494
Provider Business Mailing Address Fax Number:
724-519-7923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1811 GOLDEN MILE HWY
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15239-2827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-519-2494
Provider Business Practice Location Address Fax Number:
724-519-7923
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STONEBRAKER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-519-2494

Provider Taxonomy Codes

  • Taxonomy code: 335V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0017924710003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 817616 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 402643800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 628799 . This is a "ANTHEM BS BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00800399 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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