Provider Demographics
NPI:1932346053
Name:APOLLO MT, LLC
Entity type:Organization
Organization Name:APOLLO MT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:STIRLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-455-0292
Mailing Address - Street 1:250 CUSHMAN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4640
Mailing Address - Country:US
Mailing Address - Phone:907-455-0292
Mailing Address - Fax:907-455-0294
Practice Address - Street 1:360 ANCHORAGE ST
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925
Practice Address - Country:US
Practice Address - Phone:907-455-0292
Practice Address - Fax:907-455-0294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK20603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport