Provider Demographics
NPI:1841241015
Name:APEX HOUSE CALL DOCTORS LLC
Entity Type:Organization
Organization Name:APEX HOUSE CALL DOCTORS LLC
Other - Org Name:HOUSE CALL DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:G
Authorized Official - Last Name:RALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-446-1206
Mailing Address - Street 1:6789 SOUTHPOINT PARKWAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:904-296-1874
Mailing Address - Fax:904-296-1877
Practice Address - Street 1:6789 SOUTHPOINT PARKWAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-296-1874
Practice Address - Fax:904-296-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC4962207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9067OtherMEDICARE GROUP NUMBER