Provider Demographics
NPI:1154713055
Name:APEX MEDICAL, LLC
Entity type:Organization
Organization Name:APEX MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOODHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-271-2788
Mailing Address - Street 1:PO BOX 1148
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-1148
Mailing Address - Country:US
Mailing Address - Phone:918-298-0100
Mailing Address - Fax:918-298-0110
Practice Address - Street 1:10596 S ELM ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-3014
Practice Address - Country:US
Practice Address - Phone:918-298-0100
Practice Address - Fax:918-298-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies