Provider Demographics
NPI:1073744884
Name:ANGELCARE CENTERS, INC.
Entity Type:Organization
Organization Name:ANGELCARE CENTERS, INC.
Other - Org Name:ANGELCARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:PRITCHARD
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:770-446-1555
Mailing Address - Street 1:5180 JIMMY CARTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1618
Mailing Address - Country:US
Mailing Address - Phone:770-446-1555
Mailing Address - Fax:678-646-1969
Practice Address - Street 1:5180 JIMMY CARTER BLVD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1618
Practice Address - Country:US
Practice Address - Phone:770-446-1555
Practice Address - Fax:678-646-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA31963261Q00000X, 261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care