Provider Demographics
NPI:1477996478
Name:ANGEL ARMS NON MEDICAL & HOME HEALTH SVC LLC
Entity Type:Organization
Organization Name:ANGEL ARMS NON MEDICAL & HOME HEALTH SVC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-943-5062
Mailing Address - Street 1:310 1ST ST W
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:SC
Mailing Address - Zip Code:29924-3404
Mailing Address - Country:US
Mailing Address - Phone:803-943-5062
Mailing Address - Fax:803-943-2156
Practice Address - Street 1:310 1ST ST W
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:SC
Practice Address - Zip Code:29924-3404
Practice Address - Country:US
Practice Address - Phone:803-943-5062
Practice Address - Fax:803-943-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service
No347C00000XTransportation ServicesPrivate Vehicle