Provider Demographics
NPI:1417629445
Name:APALA FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:APALA FAMILY PRACTICE PLLC
Other - Org Name:APALA HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABUCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ACNP-BC
Authorized Official - Phone:623-584-9279
Mailing Address - Street 1:PO BOX 1543
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85372-1543
Mailing Address - Country:US
Mailing Address - Phone:623-584-9279
Mailing Address - Fax:855-978-1884
Practice Address - Street 1:12851 W BELL RD STE 118
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85378-9609
Practice Address - Country:US
Practice Address - Phone:623-584-9279
Practice Address - Fax:855-978-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ796987Medicaid