Healthcare Provider Details

I. General information

NPI: 1588342349
Provider Name (Legal Business Name): AGAPE MEDICAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 CLYBURN ST
CAMDEN SC
29020-4003
US

IV. Provider business mailing address

1611 CLYBURN ST
CAMDEN SC
29020-4003
US

V. Phone/Fax

Practice location:
  • Phone: 803-856-3379
  • Fax:
Mailing address:
  • Phone: 803-856-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Y00000X
TaxonomyHealth Information Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DIESHA DARCUS
Title or Position: CEO
Credential:
Phone: 803-856-3379