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General NPI Number Information
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NPI Number | 1245545391
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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 | 08/13/2010
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 1031 E KARSCH BLVD
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City | FARMINGTON
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State | MO
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Zip | 63640-3404
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Country | US
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Telephone | 573-756-7880
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Fax | 573-756-2669
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Provider Business Mailing Address
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Address Line | PO BOX 107
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City | FARMINGTON
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State | MO
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Zip | 63640-0107
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Country | US
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Telephone | 573-756-7880
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Fax | 573-756-2669
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Authorized Official
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Title or Position | DIRECTOR
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Name | AMELIA DORIS LEDBETTER
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Credential |
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Telephone | 573-335-4715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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