Provider Demographics
NPI:1598916876
Name:AGILUS HEALTH, INC
Entity type:Organization
Organization Name:AGILUS HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CODY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-443-8746
Mailing Address - Street 1:1305 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-4046
Mailing Address - Country:US
Mailing Address - Phone:318-443-5278
Mailing Address - Fax:318-443-1906
Practice Address - Street 1:1305 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4046
Practice Address - Country:US
Practice Address - Phone:318-443-5278
Practice Address - Fax:318-443-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1989177Medicaid
LA196575Medicare PIN