Provider Demographics
NPI:1114218443
Name:ANGELS ON WHEELS LLC
Entity Type:Organization
Organization Name:ANGELS ON WHEELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:330-896-0552
Mailing Address - Street 1:1270 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7713
Mailing Address - Country:US
Mailing Address - Phone:330-896-0552
Mailing Address - Fax:330-896-0582
Practice Address - Street 1:1270 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7713
Practice Address - Country:US
Practice Address - Phone:330-896-0552
Practice Address - Fax:330-896-0582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)