NPIMap

Organization Active NPI

Agape Community Health Center, Inc

  • Community/Retail Pharmacy
  • Jacksonville, FL
National Provider Identifier
1285396143
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
AGAPE COMMUNITY HEALTH CENTER, INC
Practice address
1680 Dunn Avenue
Suite 38
Jacksonville, FL 32218
Phone
(904) 760-4904
Fax
(904) 900-4755
NPI assigned
Oct 8, 2021
Last updated
Oct 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mia L. Jones
Title
Chief Executive Officer
Phone
(904) 800-6191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1680 Dunn Avenue
Suite 38
Jacksonville, FL 32218

Mailing address

120 King Street
Jacksonville, FL 32204
Phone (904) 760-4904

Other names 1

  • Agape Dunn Ave Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Agape Community HLTH Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1285396143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 KING STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-760-4904",
            "fax_number": "904-900-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 DUNN AVENUE",
            "address_2": "SUITE 38",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-760-4904",
            "fax_number": "904-900-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "904-800-6191"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agape Dunn Ave Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.