Provider Demographics
NPI: | 1699342063 |
---|---|
Name: | APEX CLINICARE LLC |
Entity type: | Organization |
Organization Name: | APEX CLINICARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ALEX |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HOBBS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | APRN |
Authorized Official - Phone: | 513-805-4361 |
Mailing Address - Street 1: | 8148 PRINCETON GLENDALE RD |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST CHESTER |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45069-5883 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-805-4361 |
Mailing Address - Fax: | 513-805-7760 |
Practice Address - Street 1: | 8148 PRINCETON GLENDALE RD |
Practice Address - Street 2: | |
Practice Address - City: | WEST CHESTER |
Practice Address - State: | OH |
Practice Address - Zip Code: | 45069-5883 |
Practice Address - Country: | US |
Practice Address - Phone: | 513-805-4361 |
Practice Address - Fax: | 513-805-7760 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-06-04 |
Last Update Date: | 2021-07-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0449405 | Medicaid |