Provider Demographics
NPI:1235381021
Name:APOLLO MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:APOLLO MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-484-9858
Mailing Address - Street 1:PO BOX 25195
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33320-5195
Mailing Address - Country:US
Mailing Address - Phone:954-484-9858
Mailing Address - Fax:
Practice Address - Street 1:2331 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3748
Practice Address - Country:US
Practice Address - Phone:954-484-9858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies