Provider Demographics
NPI:1124566989
Name:APOLLO CARE, LLC
Entity Type:Organization
Organization Name:APOLLO CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:JARRED
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDDING
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:573-441-8900
Mailing Address - Street 1:1917 PARIS RD
Mailing Address - Street 2:STE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5564
Mailing Address - Country:US
Mailing Address - Phone:573-441-8900
Mailing Address - Fax:573-441-8905
Practice Address - Street 1:3801 MOJAVE CT
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-4042
Practice Address - Country:US
Practice Address - Phone:573-441-8900
Practice Address - Fax:573-441-8905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170026803336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy