Provider Demographics
NPI:1124755848
Name:AGNP HEALTH LLC
Entity type:Organization
Organization Name:AGNP HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:517-225-2467
Mailing Address - Street 1:10265 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-9744
Mailing Address - Country:US
Mailing Address - Phone:517-225-2467
Mailing Address - Fax:
Practice Address - Street 1:134 S COCHRAN AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1557
Practice Address - Country:US
Practice Address - Phone:517-541-1000
Practice Address - Fax:517-543-4270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704264964OtherAPRN LICENSE