Provider Demographics
NPI:1093002362
Name:APOLLO MEDICAL MANAGEMENT
Entity Type:Organization
Organization Name:APOLLO MEDICAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KASIRAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATHAPPAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-599-6337
Mailing Address - Street 1:65418 BARKCAMP PARK RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43718-9733
Mailing Address - Country:US
Mailing Address - Phone:888-599-6337
Mailing Address - Fax:
Practice Address - Street 1:7192 N MAIN ST
Practice Address - Street 2:INDEPENDENCE URGENT CARE
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1571
Practice Address - Country:US
Practice Address - Phone:248-625-0372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site