Provider Demographics
NPI:1194021246
Name:APOLLO HEALTHCARE, LLC
Entity Type:Organization
Organization Name:APOLLO HEALTHCARE, LLC
Other - Org Name:NIAGARA RENAL WHEATFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SLOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-282-2200
Mailing Address - Street 1:3506 HYDE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14305-2204
Mailing Address - Country:US
Mailing Address - Phone:716-282-2200
Mailing Address - Fax:716-282-6178
Practice Address - Street 1:3909 FOREST PKWY
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-3709
Practice Address - Country:US
Practice Address - Phone:716-282-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment