Healthcare Provider Details

I. General information

NPI: 1013372077
Provider Name (Legal Business Name): APOLLO URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LATTNER CT STE 100
MORRISVILLE NC
27560-6843
US

IV. Provider business mailing address

101 LATTNER CT SUITE 100
MORRISVILLE NC
27560-6843
US

V. Phone/Fax

Practice location:
  • Phone: 919-297-0348
  • Fax: 919-297-0349
Mailing address:
  • Phone: 919-297-0348
  • Fax: 919-297-0349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number2007-01007
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2007-01007
License Number StateNC

VIII. Authorized Official

Name: BHAVANI LAGADAPATI
Title or Position: PRESIDENT
Credential: M.D
Phone: 919-297-0348