Provider Demographics
NPI:1407030356
Name:ANGELS HEALTH CARE CLINIC INC
Entity Type:Organization
Organization Name:ANGELS HEALTH CARE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLOWERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-349-4729
Mailing Address - Street 1:47922 ST HWY 99
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056
Mailing Address - Country:US
Mailing Address - Phone:918-349-2290
Mailing Address - Fax:918-349-2290
Practice Address - Street 1:47922 ST HWY 99
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056
Practice Address - Country:US
Practice Address - Phone:918-349-2290
Practice Address - Fax:918-349-2290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health