Healthcare Provider Details
I. General information
NPI: 1356150916
Provider Name (Legal Business Name): AGAPE CARE NORTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
374 HUDLOW RD STE B
FOREST CITY NC
28043-9444
US
IV. Provider business mailing address
187 N CHURCH ST STE 201
SPARTANBURG SC
29306-5154
US
V. Phone/Fax
- Phone: 800-932-2738
- Fax:
- Phone: 800-932-2738
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PH0002X |
| Taxonomy | Hospice and Palliative Medicine (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QH0002X |
| Taxonomy | Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAMELA
DUNCAN
Title or Position: CCO
Credential:
Phone: 800-932-2738