MEDICARE: AGRIM PEST CONTROL SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1174201883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGRIM PEST CONTROL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2116 80TH ST
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370-1323
Country	:	US
Telephone Number	:	347-723-0230
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 80TH ST
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370-1323
Country	:	US
Telephone Number	:	347-723-0230
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ALKIVIADIS GEORGE PANOPOULOS
Credential	:
Telephone Number	:	347-723-0230

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	07/11/2023

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