Provider Demographics
NPI:1811432180
Name:APOLLO MEDICAL HOLDINGS
Entity type:Organization
Organization Name:APOLLO MEDICAL HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-440-3453
Mailing Address - Street 1:10511 OLD OLIVE STREET RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-5925
Mailing Address - Country:US
Mailing Address - Phone:314-692-0611
Mailing Address - Fax:
Practice Address - Street 1:188 WOODCREST DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249
Practice Address - Country:US
Practice Address - Phone:618-407-0807
Practice Address - Fax:618-882-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267580Medicare Oscar/Certification