Provider Demographics
NPI:1932424017
Name:APEX HEART HEALTH CENTER
Entity Type:Organization
Organization Name:APEX HEART HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:912-748-3368
Mailing Address - Street 1:502 HWY 80 W
Mailing Address - Street 2:DRAWER P
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-2140
Mailing Address - Country:US
Mailing Address - Phone:912-748-3368
Mailing Address - Fax:912-748-6298
Practice Address - Street 1:114 CANAL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4153
Practice Address - Country:US
Practice Address - Phone:912-748-3368
Practice Address - Fax:912-748-6298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036757261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty