1295710168 NPI number — APOLLO HOME HEALTH CARE SERVICES, INC.

Table of content: (NPI 1295710168)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295710168 NPI number — APOLLO HOME HEALTH CARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APOLLO HOME HEALTH CARE 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:
6
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:
1295710168
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3105 S MERIDIAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73119-1022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-947-7700
Provider Business Mailing Address Fax Number:
405-947-7300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1401 SE GOLDTREE DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
PORT ST LUCIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34952-7584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-337-3600
Provider Business Practice Location Address Fax Number:
772-337-4662
Provider Enumeration Date:
12/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PETERS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
405-947-7700

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA299991834 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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