1730348285 NPI number — ANGEL PRIVATE DUTY AND HOME HEALTH INC

Table of content: (NPI 1730348285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730348285 NPI number — ANGEL PRIVATE DUTY AND HOME HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGEL PRIVATE DUTY AND HOME HEALTH INC
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:
1730348285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 PLUS PARK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-365-4424
Provider Business Mailing Address Fax Number:
615-365-0998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 PLUS PARK BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37217-1005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-365-4424
Provider Business Practice Location Address Fax Number:
615-365-0998
Provider Enumeration Date:
06/09/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PLANTINGA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
615-365-4424

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 447581 . This is a "CMS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".