| Agape Primary Care, Pllc | |
|
8380 W Emile Zola Ave # 5178 Peoria AZ 85381-4811 | |
| (623) 219-7768 | |
| (480) 436-6926 |
| Full Name | Agape Primary Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 8380 W Emile Zola Ave # 5178, Peoria, Arizona |
| Authorized Official Name and Position | Paulina Simon (OWNER) |
| Authorized Official Contact | 6232197768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Primary Care, Pllc 8380 W Emile Zola Ave # 5178 Peoria AZ 85381-4811 Ph: (623) 219-7768 | Agape Primary Care, Pllc 8380 W Emile Zola Ave # 5178 Peoria AZ 85381-4811 Ph: (623) 219-7768 |
| NPI Number | 1992236848 |
|---|---|
| Provider Enumeration Date | 03/22/2017 |
| Last Update Date | 03/22/2017 |
| Medicare PECOS PAC ID | 4880970862 |
|---|---|
| Medicare Enrollment ID | O20170405000688 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992236848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Arizona) | Primary |
| Provider Name | Valarie C Grogan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912085655 PECOS PAC ID: 5698673663 Enrollment ID: I20091002000384 |
| Provider Name | Sorana L Pop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164802690 PECOS PAC ID: 9032426358 Enrollment ID: I20150918002801 |
| Provider Name | Jane M Kinstler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235521147 PECOS PAC ID: 1456651991 Enrollment ID: I20151204001668 |
| Provider Name | Paulina Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962959346 PECOS PAC ID: 9830487495 Enrollment ID: I20161013001927 |
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