Agape Upper Cervical Health Center, Inc.

Organization Active NPI Exclusive Provider Organization · Alpharetta, GA

NPI 1912342197 · NPPES record last updated May 1, 2013

Key facts

NPI
1912342197
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
License
008584 (GA)
Legal business name
AGAPE UPPER CERVICAL HEALTH CENTER, INC.
Practice address
1122 Cambridge SQ
Suite a
Alpharetta, GA 30009-1858
Phone
(678) 393-8833
NPI assigned
May 1, 2013
Organization subpart
No

Authorized official

Name
Dr. Charmaine Antonia Herman, D.C
Title
Cfo/Doctor
Phone
(678) 393-8833

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130619000500 GA Part B Supplier - Clinic/Group Practice 3476792672 Receives reassigned benefits from 1 practitioner
Practice locations: Alpharetta, GA

National Provider Directory

Locations

1122 Cambridge Sq
Ste A
Alpharetta, GA 30009
Phone (678) 393-8833

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 008584 GA Yes

Addresses

Primary practice location

1122 Cambridge SQ
Suite a
Alpharetta, GA 30009-1858

Mailing address

1122 Cambridge SQ
Suite a
Alpharetta, GA 30009-1858
Phone (678) 393-8833

Other providers in Alpharetta, GA

All providers in Alpharetta, GA · Exclusive Provider Organization in Georgia

Sources for this page

Verify at the official NPI Registry.