| Agave Solutions Pllc | |
|
10550 W Mcdowell Rd Avondale AZ 85392-4864 | |
| (480) 565-3035 | |
| Not Available |
| Full Name | Agave Solutions Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10550 W Mcdowell Rd, Avondale, Arizona |
| Authorized Official Name and Position | Aaron Kramer (OWNER) |
| Authorized Official Contact | 6233082472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agave Solutions Pllc 20118 N 67th Ave Ste 300-609 Glendale AZ 85308-4621 Ph: () - | Agave Solutions Pllc 10550 W Mcdowell Rd Avondale AZ 85392-4864 Ph: (480) 565-3035 |
| NPI Number | 1619594546 |
|---|---|
| Provider Enumeration Date | 06/26/2020 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Medicare PECOS PAC ID | 0941625651 |
|---|---|
| Medicare Enrollment ID | O20200728004000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619594546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Stephen L Mecham |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083068050 PECOS PAC ID: 1759648348 Enrollment ID: I20180702002215 |
| Provider Name | Aaron S Kramer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558715490 PECOS PAC ID: 8123454717 Enrollment ID: I20200129002664 |
| Provider Name | Chad Done |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457087546 PECOS PAC ID: 5799169678 Enrollment ID: I20220825003074 |
| Provider Name | Beau Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538895594 PECOS PAC ID: 6608238142 Enrollment ID: I20230815001812 |
| Provider Name | Chante Kenyada Dickerson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871055491 PECOS PAC ID: 0547614828 Enrollment ID: I20230921000907 |
| Provider Name | Samuel Walter Timm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780248831 PECOS PAC ID: 5991156242 Enrollment ID: I20240110004904 |
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