Provider Demographics
NPI:1811749716
Name:AGAPE MEDICAL SERVICES, PLLC
Entity type:Organization
Organization Name:AGAPE MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSSITANT
Authorized Official - Prefix:
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:910-733-5592
Mailing Address - Street 1:413 FAITH RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-3409
Mailing Address - Country:US
Mailing Address - Phone:910-733-5592
Mailing Address - Fax:
Practice Address - Street 1:413 FAITH RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-3409
Practice Address - Country:US
Practice Address - Phone:910-733-5592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty