| Agape Family Healthcare Clinic | |
|
1124 Whitehall St Jackson TN 38301-8742 | |
| (731) 616-4468 | |
| Not Available |
| Full Name | Agape Family Healthcare Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1124 Whitehall St, Jackson, Tennessee |
| Authorized Official Name and Position | Cynthia Early (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 7316164468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Family Healthcare Clinic 2156 N Highland Ave # B108 Jackson TN 38305-4915 Ph: (731) 616-4468 | Agape Family Healthcare Clinic 1124 Whitehall St Jackson TN 38301-8742 Ph: (731) 616-4468 |
| NPI Number | 1083984298 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 01/04/2012 |
| Medicare PECOS PAC ID | 1052579893 |
|---|---|
| Medicare Enrollment ID | O20120224000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083984298 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Cynthia A Early |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881644862 PECOS PAC ID: 5597729954 Enrollment ID: I20041116000108 |
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