Healthcare Provider Details

I. General information

NPI: 1447851274
Provider Name (Legal Business Name): APOLLO MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16104A HART ST
VAN NUYS CA
91406-3903
US

IV. Provider business mailing address

16104A HART ST
VAN NUYS CA
91406-3903
US

V. Phone/Fax

Practice location:
  • Phone: 818-257-1457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ANNA BOGDANYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-257-1457