Provider Demographics
NPI:1467496653
Name:AGAPE PRESCRIPTIONS R US
Entity Type:Organization
Organization Name:AGAPE PRESCRIPTIONS R US
Other - Org Name:DARIEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GREY
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:912-437-3784
Mailing Address - Street 1:1229 NORTHWAY STREET
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:GA
Mailing Address - Zip Code:31305
Mailing Address - Country:US
Mailing Address - Phone:912-437-3784
Mailing Address - Fax:912-437-6242
Practice Address - Street 1:1229 NORTHWAY STREET
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:GA
Practice Address - Zip Code:31305
Practice Address - Country:US
Practice Address - Phone:912-437-3784
Practice Address - Fax:912-437-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008564332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300035871AMedicaid
GA008564OtherGEORGIA STATE LISCENSE
GA1149295OtherNCPDP NUMBER
GA000928925BMedicaid
GA000928925AMedicaid
GA000928925AMedicaid
GA4359100001Medicare NSC
GA008564OtherGEORGIA STATE LISCENSE