MEDICARE: APOLLO MEDICAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	00000645	TN
2	332BX2000X	Oxygen Equipment & Supplies (DME)	00000645	TN
3	332B00000X	Durable Medical Equipment & Medical Supplies	00000645	TN

General Provider Information

NPI Number	:	1285667329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APOLLO MEDICAL LLC

Provider Business Mailing Address
First Line	:	1838 ELM HILL PIKE
Second Line	:	SUITE 125
City	:	NASHVILLE
State	:	TN
Zip	:	37210-3726
Country	:	US
Telephone Number	:	615-376-9665
Fax Number	:	615-376-4570

Provider Business Practice Location Address
First Line	:	1838 ELM HILL PIKE
Second Line	:	SUITE 125
City	:	NASHVILLE
State	:	TN
Zip	:	37210-3726
Country	:	US
Telephone Number	:	615-376-9665
Fax Number	:	615-376-4570

Authorized Official
Title or Position	:	MBR
Name	:	MR. MICHAEL MCCONNELL
Credential	:
Telephone Number	:	615-376-9665

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	11/15/2007

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Directions to “APOLLO MEDICAL LLC ” Practice Location

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