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General NPI Number Information
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NPI Number | 1194021246
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Entity Type | Organization
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Legal Business Name | APOLLO HEALTHCARE, LLC
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 3909 FOREST PKWY
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-3709
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Country | US
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Telephone | 716-282-6188
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 HYDE PARK BLVD
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City | NIAGARA FALLS
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State | NY
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Zip | 14305-2204
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Country | US
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Telephone | 716-282-2200
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Fax | 716-282-6178
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. HENRY MICHAEL SLOMA
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Credential |
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Telephone | 716-282-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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