Provider Demographics
NPI:1164921557
Name:LANGOEHR, ANGIE KAY (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:KAY
Last Name:LANGOEHR
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261
Mailing Address - Street 2:
Mailing Address - City:MAGNETIC SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:43036-0261
Mailing Address - Country:US
Mailing Address - Phone:937-309-5078
Mailing Address - Fax:
Practice Address - Street 1:15 CATHERINE WEST STREET
Practice Address - Street 2:
Practice Address - City:MAGNETIC SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:43036
Practice Address - Country:US
Practice Address - Phone:937-309-5078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0237068Medicaid