| Agape Clinic Inc | |
|
2140 W 24th St Ste B Yuma AZ 85364-8877 | |
| (928) 459-3400 | |
| (928) 459-2077 |
| Full Name | Agape Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2140 W 24th St Ste B, Yuma, Arizona |
| Authorized Official Name and Position | John Ernest Williams (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9284593400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Clinic Inc 2140 W 24th St Ste B Yuma AZ 85364-8877 Ph: (928) 503-4060 | Agape Clinic Inc 2140 W 24th St Ste B Yuma AZ 85364-8877 Ph: (928) 459-3400 |
| NPI Number | 1922720333 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 09/13/2022 |
| Medicare PECOS PAC ID | 1153776729 |
|---|---|
| Medicare Enrollment ID | O20231017002975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922720333 | NPI | - | NPPES |
| Provider Name | Danielle L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912171927 PECOS PAC ID: 2769534601 Enrollment ID: I20121109000392 |
| Provider Name | Peter Dashkoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912141367 PECOS PAC ID: 1951547082 Enrollment ID: I20130416000566 |
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