Apexcare PA
Organization Active NPI Internal Medicine Physician · Lugoff, SC
NPI 1508958216 · NPPES record last updated Mar 10, 2011
Key facts
- NPI
- 1508958216
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 20381 (SC)
- Legal business name
- APEXCARE PA
- Practice address
- 1165 Highway 1 S
Suite 200
Lugoff, SC 29078-8966 - Phone
- (803) 408-0225
- Fax
- (803) 408-0729
- NPI assigned
- Sep 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Olajide A. Balogun, M.D.
- Title
- Medical Director
- Phone
- (803) 408-0225
Practitioners 1
-
Olajide A. Balogun, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061205000469 | SC | Part B Supplier - Clinic/Group Practice | 2466451299 |
Receives reassigned benefits from 1 practitioner Practice locations: Lugoff, SC |
National Provider Directory
Locations
116 Standard Warehouse Rd
Lugoff, SC 29078
Phone (803) 408-0225
116 Standard Warehouse Rd
Ste 200
Lugoff, SC 29078
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 20381 | SC | Yes |
| Pediatrics Physician |
208000000X | 20381 | SC |
Addresses
Primary practice location
1165 Highway 1 S
Suite 200
Lugoff, SC 29078-8966
Mailing address
1165 Highway 1 S
Suite 200
Lugoff, SC 29078-8966
Phone (803) 408-0225
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203817 | Medicaid | SC |
Other providers in Lugoff, SC
- Theresa Rose Alderson
- Alice J. Brooks, MD, PA
- Thomas Cloud Anderson
- Aparhealth Primary Care LLC
- Aparhealth Primary Care, LLC
- Ark Therapeutic Services, Inc
- Olajide A. Balogun
- Tonya Barkley
- Elaine B Baxley
- Ryan Bing
All providers in Lugoff, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.