Provider Demographics
NPI:1598092785
Name:AGORA WORLDWIDE UNLIMITED LLC
Entity Type:Organization
Organization Name:AGORA WORLDWIDE UNLIMITED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:MARCEL
Authorized Official - Last Name:LONDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-375-8903
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-0094
Mailing Address - Country:US
Mailing Address - Phone:414-375-8903
Mailing Address - Fax:414-375-8904
Practice Address - Street 1:200 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8618
Practice Address - Country:US
Practice Address - Phone:414-375-8903
Practice Address - Fax:414-375-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health