Provider Demographics
NPI:1164799425
Name:APEX HEALTHCARE MEDICAL CENTER INC
Entity Type:Organization
Organization Name:APEX HEALTHCARE MEDICAL CENTER INC
Other - Org Name:APEX NEPHROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSCROP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-754-6483
Mailing Address - Street 1:41889 E FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-5042
Mailing Address - Country:US
Mailing Address - Phone:951-652-8700
Mailing Address - Fax:951-766-9944
Practice Address - Street 1:1515 W FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3817
Practice Address - Country:US
Practice Address - Phone:951-929-1333
Practice Address - Fax:951-929-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty