| Agape Family Healthcare Llc | |
|
1037 E Old Hickory Blvd Madison TN 37115 | |
| (615) 865-3994 | |
| (615) 865-8176 |
| Full Name | Agape Family Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1037 E Old Hickory Blvd, Madison, Tennessee |
| Authorized Official Name and Position | Beverly Davidson (OWNER) |
| Authorized Official Contact | 6158653994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Family Healthcare Llc Po Box 568 Old Hickory TN 37138-0568 Ph: (615) 944-2474 | Agape Family Healthcare Llc 1037 E Old Hickory Blvd Madison TN 37115 Ph: (615) 865-3994 |
| NPI Number | 1154654440 |
|---|---|
| Provider Enumeration Date | 09/17/2009 |
| Last Update Date | 05/16/2018 |
| Medicare PECOS PAC ID | 7911042122 |
|---|---|
| Medicare Enrollment ID | O20100226000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154654440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 13671 (Tennessee) | Primary |
| Provider Name | Beverly Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144473547 PECOS PAC ID: 5496818171 Enrollment ID: I20090106000691 |
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