Provider Demographics
NPI:1851561302
Name:APOGEE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:APOGEE MEDICAL GROUP INC
Other - Org Name:APOGEE PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-778-3600
Mailing Address - Street 1:PO BOX 708850
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-8850
Mailing Address - Country:US
Mailing Address - Phone:866-869-2395
Mailing Address - Fax:801-352-9502
Practice Address - Street 1:2525 E CAMELBACK RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4219
Practice Address - Country:US
Practice Address - Phone:602-778-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCJ5331OtherRR-MEDICARE
AZCJ5331OtherRR-MEDICARE