1306130497 NPI number — ANGELS AROUND THE CLOCK HOMECARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306130497 NPI number — ANGELS AROUND THE CLOCK HOMECARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGELS AROUND THE CLOCK HOMECARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306130497
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2851 STAGE VILLAGE CV STE 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARTLETT
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38134-4683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-388-0600
Provider Business Mailing Address Fax Number:
901-389-3638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2851 STAGE VILLAGE CV STE 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARTLETT
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38134-4683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-388-0600
Provider Business Practice Location Address Fax Number:
901-389-3638
Provider Enumeration Date:
06/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
JANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
901-388-0600

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  L00000007629 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4266264 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".




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