Provider Demographics
NPI:1326483298
Name:APOLLO HOSPICE INC
Entity Type:Organization
Organization Name:APOLLO HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILTSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-995-0064
Mailing Address - Street 1:1224 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:469-587-7942
Mailing Address - Fax:469-916-9535
Practice Address - Street 1:4230 LBJ FWY
Practice Address - Street 2:SUITE 153
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244
Practice Address - Country:US
Practice Address - Phone:469-587-7942
Practice Address - Fax:469-916-9535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based