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General NPI Number Information
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NPI Number | 1992010888
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Entity Type | Organization
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Legal Business Name | APOLLO HEALTHCARE SUPPLY INC
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 5200 SOUTHCENTER BLVD SUITE 200
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City | TUKWILA
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State | WA
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Zip | 98188-2356
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Country | US
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Telephone | 206-244-0009
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Fax | 206-243-0079
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Provider Business Mailing Address
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Address Line | 5200 SOUTHCENTER BLVD SUITE 200
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City | TUKWILA
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State | WA
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Zip | 98188-2356
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Country | US
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Telephone | 206-244-0009
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Fax | 206-243-0079
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAUZIAR NIKZAD
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Credential | M.D.
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Telephone | 425-351-0091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 603029452
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License Number State | WA
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