MEDICARE: APEX HOME HEALTHCARE & SUPPLIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		CA

General Provider Information

NPI Number	:	1689831059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX HOME HEALTHCARE & SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	1435 N WATERMAN AVE
Second Line	:	SUITE B
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92404-5326
Country	:	US
Telephone Number	:	909-888-2929
Fax Number	:	909-888-3333

Provider Business Practice Location Address
First Line	:	1435 N WATERMAN AVE
Second Line	:	SUITE B
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92404-5326
Country	:	US
Telephone Number	:	909-888-2929
Fax Number	:	909-888-3333

Authorized Official
Title or Position	:	CEO
Name	:	MR. KOLA OBILEYE
Credential	:
Telephone Number	:	909-578-2553

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	12/24/2008

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