Organization · NPI-2

Agave Family Medicine & Breast Feeding Support Center LLC

Family Medicine · Tucson, AZ

NPI number1265165484
StatusActive
Last updated in NPPESSep 30, 2022

Details

NPI
1265165484
Entity type
Organization (NPI-2)
Legal business name
Agave Family Medicine & Breast Feeding Support Center LLC
Organization subpart
No
Enumeration date
Jul 6, 2022
Certification date
Sep 30, 2022
Last updated
Sep 30, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

1925 W Orange Grove Rd Ste 201
Tucson, AZ 85704-1151

Phone 520-372-2167

Mailing address

1925 W Orange Grove Rd Ste 201
Tucson, AZ 85704-1151

Phone 520-372-2167

Authorized official

Mary C Harrel
Director
6029994659

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