Provider Demographics
NPI: | 1518380450 |
---|---|
Name: | ANGEL MEDICAL CENTER, INC. |
Entity Type: | Organization |
Organization Name: | ANGEL MEDICAL CENTER, INC. |
Other - Org Name: | ANGEL SURGICAL ASSOCIATES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RHONDA |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | MILLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 828-651-4152 |
Mailing Address - Street 1: | PO BOX 1209 |
Mailing Address - Street 2: | |
Mailing Address - City: | FRANKLIN |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28744-0569 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-213-1500 |
Mailing Address - Fax: | 828-651-6570 |
Practice Address - Street 1: | 121 RIVERVIEW ST |
Practice Address - Street 2: | |
Practice Address - City: | FRANKLIN |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28734-2611 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-369-4402 |
Practice Address - Fax: | 828-369-4403 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | ANGEL MEDICAL CENTER, INC. |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2014-01-29 |
Last Update Date: | 2016-10-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty |