Provider Demographics
NPI:1700273745
Name:APOGEE MEDICAL GROUP
Entity Type:Organization
Organization Name:APOGEE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:JOLENE
Authorized Official - Last Name:LUJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-661-9279
Mailing Address - Street 1:3917 WEST RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2275
Mailing Address - Country:US
Mailing Address - Phone:505-661-9279
Mailing Address - Fax:
Practice Address - Street 1:3917 WEST RD
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2275
Practice Address - Country:US
Practice Address - Phone:505-661-9279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital