Organization
AGAPE PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R RANDALL SUKMAN M.D. (OWNER)
(417) 339-3033
Entity
Organization
Contact information
Practice address
2331 S BUSINESS HIGHWAY 65, HOLLISTER, MO 65672-5105
(417) 339-3033
(417) 339-9133
Mailing address
2331 S BUSINESS HIGHWAY 65, HOLLISTER, MO 65672-5105
(417) 339-3033
(417) 339-9133
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
109959
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
598529105
—
MO
Enumeration date
04/19/2007
Last updated
10/18/2010
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