Provider Demographics
NPI:1073906616
Name:APEX CARDIOLOGY PC
Entity Type:Organization
Organization Name:APEX CARDIOLOGY PC
Other - Org Name:RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-989-1007
Mailing Address - Street 1:557 W PARK PL
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-2027
Mailing Address - Country:US
Mailing Address - Phone:731-989-1007
Mailing Address - Fax:731-988-0704
Practice Address - Street 1:557 W PARK PL
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TN
Practice Address - Zip Code:38340-2027
Practice Address - Country:US
Practice Address - Phone:731-989-1007
Practice Address - Fax:731-988-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN443960OtherMEDICARE PTAN FOR RURAL HEALTH CLINIC