Organization
AGAVE PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHETT S ANDERSEN (MEMBER)
(801) 420-0077
Entity
Organization
Contact information
Practice address
3240 E UNION HILLS DR STE 145, PHOENIX, AZ 85050-2652
(602) 855-3500
(855) 930-3500
Mailing address
1008 N 1100 E, PLEASANT GROVE, UT 84062-2066
(801) 420-0077
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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