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AGAPE PRIMARY CARE INC NPI 1861619025


NPI Information

NPI: 1861619025
Provider Name: AGAPE PRIMARY CARE INC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
2331 S BUSINESS HIGHWAY 65
HOLLISTER, MO
ZIP 65672
Phone: (417) 339-3033
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AGAPE PRIMARY CARE INC is a rural health clinic center in Hollister, MO. AGAPE PRIMARY CARE INC NPI is 1861619025. The provider is registered as an organization entity type.

The provider's business location address is:

2331 S BUSINESS HIGHWAY 65
HOLLISTER, MO
ZIP 65672-105
Phone: (417) 339-3033
Fax: (417) 339-9133

The provider's authorized official is R Randall Sukman .
The authorized official title is Owner and has the following contact phone number (417) 339-3033.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 10/18/2010.


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
1261QR1300XClinic/CenterRural Health109959MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1263922MEDICARE ID-TYPE UNSPECIFIEDMISSOURIMEDICARE PROVIDER NUMBER
2E10825MEDICARE UPINMISSOURI
3598529105MEDICAIDMISSOURI

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: 5/5/2024
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