Provider Demographics
NPI:1457942021
Name:APOLLO HEALTHCARE AND DIAGNOSTICS LLC
Entity type:Organization
Organization Name:APOLLO HEALTHCARE AND DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:S
Authorized Official - Last Name:EMBRY
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:480-701-3315
Mailing Address - Street 1:3370 N HAYDEN RD # 123215
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4717 E HILTON AVE STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6400
Practice Address - Country:US
Practice Address - Phone:480-701-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service