Healthcare Provider Details

I. General information

NPI: 1093094682
Provider Name (Legal Business Name): APEX TRAVEL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2011
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 L ST NW SUITE 204
WASHINGTON DC
20036-5002
US

IV. Provider business mailing address

1900 L ST NW SUITE 204
WASHINGTON DC
20036-5002
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-5001
  • Fax: 202-293-5011
Mailing address:
  • Phone: 202-293-5001
  • Fax: 202-293-5011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateDC

VIII. Authorized Official

Name: MRS. JANE O DARKO
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 202-293-5001