Provider Demographics
NPI:1598427734
Name:APOLLO MEDCO, LLC
Entity Type:Organization
Organization Name:APOLLO MEDCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNWODY
Authorized Official - Suffix:III
Authorized Official - Credentials:CLIA LAB DIRECTOR
Authorized Official - Phone:404-281-7753
Mailing Address - Street 1:7295 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5366
Mailing Address - Country:US
Mailing Address - Phone:404-281-7753
Mailing Address - Fax:
Practice Address - Street 1:3365 PIEDMONT RD NE STE 1400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1795
Practice Address - Country:US
Practice Address - Phone:404-574-5870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory