Provider Demographics
NPI:1134661762
Name:APEX INTEGRATED MEDICINE, P.C.
Entity Type:Organization
Organization Name:APEX INTEGRATED MEDICINE, P.C.
Other - Org Name:REVIVE MEDSPA & INTEGRATIVE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:FIENI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-263-9979
Mailing Address - Street 1:2371 BUCHANAN TRAIL WEST
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-8306
Mailing Address - Country:US
Mailing Address - Phone:717-263-9979
Mailing Address - Fax:717-263-9008
Practice Address - Street 1:2371 BUCHANAN TRAIL WEST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-8306
Practice Address - Country:US
Practice Address - Phone:717-263-9979
Practice Address - Fax:717-263-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty