Healthcare Provider Details

I. General information

NPI: 1104643717
Provider Name (Legal Business Name): APOLLO WOUNDCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3217 CHARTRES ST
NEW ORLEANS LA
70117-6712
US

IV. Provider business mailing address

3217 CHARTRES ST
NEW ORLEANS LA
70117-6712
US

V. Phone/Fax

Practice location:
  • Phone: 228-865-1330
  • Fax:
Mailing address:
  • Phone: 228-865-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN AGANS
Title or Position: OWNER
Credential: MD
Phone: 228-865-1330