Provider Demographics
NPI:1053467183
Name:APEX SURGICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:APEX SURGICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOULLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:770-509-9801
Mailing Address - Street 1:2900 DELK RD SE
Mailing Address - Street 2:SUITE 700 RM 166
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5320
Mailing Address - Country:US
Mailing Address - Phone:770-509-9801
Mailing Address - Fax:
Practice Address - Street 1:2900 DELK RD SE
Practice Address - Street 2:SUITE 700 RM 166
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5320
Practice Address - Country:US
Practice Address - Phone:770-509-9801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty