| Agape Community Integrated Health Systems, Inc | |
|
5536 Old National Hwy Suite 100 Atlanta GA 30349 | |
| (404) 564-4796 | |
| (404) 564-6487 |
| Full Name | Agape Community Integrated Health Systems, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5536 Old National Hwy, Atlanta, Georgia |
| Authorized Official Name and Position | Aisha D. Frazier (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 4045646486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Community Integrated Health Systems, Inc P.o. Box 10938 Atlanta GA 30310 Ph: (404) 564-6486 | Agape Community Integrated Health Systems, Inc 5536 Old National Hwy Suite 100 Atlanta GA 30349 Ph: (404) 564-4796 |
| NPI Number | 1578090601 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 3971866278 |
|---|---|
| Medicare Enrollment ID | O20180419002301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578090601 | NPI | - | NPPES |
| Provider Name | Linus Onyemaechi Ejim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922091990 PECOS PAC ID: 3173504776 Enrollment ID: I20040528000694 |
| Provider Name | Reginald Drumgoole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689743270 PECOS PAC ID: 7113954447 Enrollment ID: I20050719000594 |
| Provider Name | Nancy Adiri |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1871967208 PECOS PAC ID: 4789985839 Enrollment ID: I20151215002549 |
| Provider Name | Dorothy Nonye Adike |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780221481 PECOS PAC ID: 0345664371 Enrollment ID: I20200722003320 |
| Provider Name | Jovita Ngozi Anyanwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134870793 PECOS PAC ID: 1355728809 Enrollment ID: I20220523000687 |
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