Provider Demographics
NPI:1164460648
Name:APOLLO HEALTH SYSTEMS
Entity Type:Organization
Organization Name:APOLLO HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-777-0022
Mailing Address - Street 1:920 HAMPSHIRE RD
Mailing Address - Street 2:SUITE A28
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2816
Mailing Address - Country:US
Mailing Address - Phone:805-777-0022
Mailing Address - Fax:805-235-2050
Practice Address - Street 1:920 HAMPSHIRE RD
Practice Address - Street 2:SUITE A28
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2816
Practice Address - Country:US
Practice Address - Phone:805-777-0022
Practice Address - Fax:805-235-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100-746736332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5736560001Medicare NSC