Provider Demographics
NPI:1689064420
Name:AGAPE HEALTH SYSTEMS
Entity type:Organization
Organization Name:AGAPE HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:OLANRELE
Authorized Official - Middle Name:OLADIPO
Authorized Official - Last Name:FADIORA
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:443-865-7549
Mailing Address - Street 1:6707 WHITESTONE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4106
Mailing Address - Country:US
Mailing Address - Phone:443-865-7549
Mailing Address - Fax:
Practice Address - Street 1:2300 GARRISON BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-2335
Practice Address - Country:US
Practice Address - Phone:410-362-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care