Healthcare Provider Details

I. General information

NPI: 1881324481
Provider Name (Legal Business Name): APEX OSN SC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 AMENDMENT AVE STE 101
ROCK HILL SC
29732-3042
US

IV. Provider business mailing address

11650 ALPHARETTA HWY STE 100
ROSWELL GA
30076-3805
US

V. Phone/Fax

Practice location:
  • Phone: 704-771-1811
  • Fax:
Mailing address:
  • Phone: 704-771-1811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ERIK T BENDIKS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 404-644-2700