Provider Demographics
NPI:1164184016
Name:APEX TELEHEALTH CLINIC LLC
Entity Type:Organization
Organization Name:APEX TELEHEALTH CLINIC LLC
Other - Org Name:JOLLY HOME CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:NP-BC
Authorized Official - Phone:404-877-2022
Mailing Address - Street 1:700 MARIETTA ST NW STE C
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-5726
Mailing Address - Country:US
Mailing Address - Phone:800-619-6337
Mailing Address - Fax:404-999-6426
Practice Address - Street 1:700 MARIETTA ST NW STE C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5726
Practice Address - Country:US
Practice Address - Phone:800-619-6337
Practice Address - Fax:404-999-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty