AGAVE THERAPEUTICS PLLC NPI 1215586664

NPI Information

  • NPI: 1215586664
  • Provider Name: AGAVE THERAPEUTICS PLLC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Address: 11022 S 51ST ST STE 101
    PHOENIX, AZ
    ZIP 85044
  • Phone: (708) 308-0852

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NPI Details

AGAVE THERAPEUTICS PLLC is a health service clinic center in Phoenix, AZ. AGAVE THERAPEUTICS PLLC NPI is 1215586664. The provider is registered as an organization entity type.

The provider's business location address is:

11022 S 51ST ST STE 101
PHOENIX, AZ
ZIP 85044-789
Phone: (708) 308-0852
Fax: (480) 383-6371

The provider's authorized official is Janet Kay Olson .
The authorized official title is Nurse Practitioner and has the following contact phone number (708) 308-0852.

The enumeration date for this NPI number is 9/9/2019 and was last updated on 9/9/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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