| Agape Family Services | |
|
319 N Litchfield Rd Ste 105 Goodyear AZ 85338-1256 | |
| (623) 224-1162 | |
| Not Available |
| Full Name | Agape Family Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 319 N Litchfield Rd Ste 105, Goodyear, Arizona |
| Authorized Official Name and Position | Wayne M Mackenzie (CEO) |
| Authorized Official Contact | 6232241162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Family Services 319 N Litchfield Rd Suite 105 Goodyear AZ 85338-1256 Ph: () - | Agape Family Services 319 N Litchfield Rd Ste 105 Goodyear AZ 85338-1256 Ph: (623) 224-1162 |
| NPI Number | 1609271659 |
|---|---|
| Provider Enumeration Date | 11/01/2014 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Medicare PECOS PAC ID | 6103256870 |
|---|---|
| Medicare Enrollment ID | O20200420003393 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609271659 | NPI | - | NPPES |
| QXIPQ0000098776 | Other | AZ | AHCCCS |
| PDZ-0000000-27067 | Medicaid | AZ |
| Provider Name | Wayne Mackenzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144589086 PECOS PAC ID: 5092958215 Enrollment ID: I20130906000484 |
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