Provider Demographics
NPI:1285667329
Name:APOLLO MEDICAL LLC
Entity Type:Organization
Organization Name:APOLLO MEDICAL LLC
Other - Org Name:ABEL HOMECARE/THE PEDIATRIC COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-376-9665
Mailing Address - Street 1:1838 ELM HILL PIKE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3726
Mailing Address - Country:US
Mailing Address - Phone:615-376-9665
Mailing Address - Fax:615-376-4570
Practice Address - Street 1:1838 ELM HILL PIKE
Practice Address - Street 2:SUITE 125
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3726
Practice Address - Country:US
Practice Address - Phone:615-376-9665
Practice Address - Fax:615-376-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000645332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5745170001Medicare NSC