Organization · NPI-2

Agile Healthcare, LLC

Internal Medicine, Nephrology · Phoenix, AZ

NPI number1992350813
StatusActive
Last updated in NPPESSep 12, 2019

Details

NPI
1992350813
Entity type
Organization (NPI-2)
Legal business name
Agile Healthcare, LLC
Organization subpart
No
Enumeration date
Aug 7, 2019
Last updated
Sep 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RN0300X Internal Medicine, Nephrology––Yes
207RP1001X Internal Medicine, Pulmonary Disease––
2084N0400X Psychiatry & Neurology, Neurology––

Practice location

6036 N 19th Ave Ste 502
Phoenix, AZ 85015-2143

Phone 623-738-0193

Mailing address

6036 N 19th Ave Ste 502
Phoenix, AZ 85015-2143

Phone 623-738-0193

Authorized official

Mhd Kussay Samkari
MD
6027415504

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