| Agape Primary Care Inc | |
|
2331 S Business Highway 65 Hollister MO 65672-5105 | |
| (417) 339-3033 | |
| (417) 339-9133 |
| Full Name | Agape Primary Care Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 2331 S Business Highway 65, Hollister, Missouri |
| Authorized Official Name and Position | R Randall Sukman (OWNER) |
| Authorized Official Contact | 4173393033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Primary Care Inc 2331 S Business Highway 65 Hollister MO 65672-5105 Ph: (417) 339-3033 | Agape Primary Care Inc 2331 S Business Highway 65 Hollister MO 65672-5105 Ph: (417) 339-3033 |
| NPI Number | 1861619025 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 10/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861619025 | NPI | - | NPPES |
| 598529105 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 109959 (Missouri) | Primary |
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