Provider Demographics
NPI:1437298411
Name:GUARDIAN ANGEL HEALTHCARE INC., II
Entity Type:Organization
Organization Name:GUARDIAN ANGEL HEALTHCARE INC., II
Other - Org Name:PATIENTS CHOICE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-782-9997
Mailing Address - Street 1:41 SOUTH HALL ROAD
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:MS
Mailing Address - Zip Code:39117-8057
Mailing Address - Country:US
Mailing Address - Phone:601-624-2770
Mailing Address - Fax:
Practice Address - Street 1:347 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:MS
Practice Address - Zip Code:39153-6011
Practice Address - Country:US
Practice Address - Phone:601-624-2770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUARDIAN ANGEL HEALTHCARE INC., II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital