1801275599 NPI number — APEX HEALTHCARE SERVICES, LLC

Table of content: (NPI 1801275599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801275599 NPI number — APEX HEALTHCARE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APEX HEALTHCARE SERVICES, 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:
1801275599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3310 MARKET STREET
Provider Second Line Business Mailing Address:
SUITE B, SECOND FLOOR
Provider Business Mailing Address City Name:
CAMP HILL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17011-4460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-412-4154
Provider Business Mailing Address Fax Number:
717-409-8635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3310 MARKET STREET
Provider Second Line Business Practice Location Address:
SUITE B, SECOND FLOOR
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-4460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-412-4154
Provider Business Practice Location Address Fax Number:
717-409-8635
Provider Enumeration Date:
05/27/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OGUNNAIKE
Authorized Official First Name:
OLUFEMI
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR/CEO
Authorized Official Telephone Number:
717-412-4154

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  28753601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X , with the licence number: A-6418069 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 102986580 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28753601 . This is a "DEPARTMENT OF HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: A-6418069 . This is a "PUC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".