MEDICARE: APEX DIAGNOSTIC, INC.

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	174400000X	Specialist

General Provider Information

NPI Number	:	1700286705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX DIAGNOSTIC, INC.

Provider Business Mailing Address
First Line	:	455 E PIKES PEAK AVE
Second Line	:	SUITE #220
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 E PIKES PEAK AVE
Second Line	:	SUITE #220
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3648
Country	:	US
Telephone Number	:	719-338-6715
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MR. ANDREW HARRIS
Credential	:
Telephone Number	:	719-338-6715

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/27/2014

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