Provider Demographics
NPI:1912060492
Name:AGAPE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:AGAPE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAPOLEON
Authorized Official - Middle Name:CASTRICIONES
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MEMBER
Authorized Official - Phone:805-207-3870
Mailing Address - Street 1:461 FAIRBOURNE PL
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-8325
Mailing Address - Country:US
Mailing Address - Phone:805-207-3870
Mailing Address - Fax:
Practice Address - Street 1:3645 SAVIERS RD
Practice Address - Street 2:STE. 3
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-6221
Practice Address - Country:US
Practice Address - Phone:805-247-0322
Practice Address - Fax:805-486-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTN00876F343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)