Organization · NPI-2

Agape Primary Care, PLLC

Family Medicine · Peoria, AZ

NPI number1992236848
StatusActive
Last updated in NPPESMar 22, 2017

Details

NPI
1992236848
Entity type
Organization (NPI-2)
Legal business name
Agape Primary Care, PLLC
Organization subpart
No
Enumeration date
Mar 22, 2017
Last updated
Mar 22, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine–AZYes

Practice location

8380 W Emile Zola Ave # 5178
Peoria, AZ 85381-4811

Phone 623-219-7768 · Fax 480-436-6926

Mailing address

8380 W Emile Zola Ave # 5178
Peoria, AZ 85381-4811

Phone 623-219-7768 · Fax 480-436-6926

Authorized official

Paulina Simon
Owner
6232197768

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