Healthcare Provider Details

I. General information

NPI: 1033683156
Provider Name (Legal Business Name): AGHAPY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2019
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 S 25TH ST
FORT PIERCE FL
34947-4796
US

IV. Provider business mailing address

2215 S 25TH ST
FORT PIERCE FL
34947-4796
US

V. Phone/Fax

Practice location:
  • Phone: 772-257-6663
  • Fax: 772-257-6581
Mailing address:
  • Phone: 772-257-6663
  • Fax: 772-257-6581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. EHAB TADROUS
Title or Position: OWNER
Credential:
Phone: 772-713-3150