1174794994 NPI number — ANGELS ON CALL, LTD

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 1174794994 NPI number — ANGELS ON CALL, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANGELS ON CALL, LTD
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:
1174794994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
32 RED HILL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17074-8706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-567-7937
Provider Business Mailing Address Fax Number:
717-567-7956

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32 RED HILL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17074-8706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-567-7937
Provider Business Practice Location Address Fax Number:
717-567-7956
Provider Enumeration Date:
03/19/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAWLER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-567-7937

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)