Provider Demographics
NPI:1619245537
Name:GOLDEN ANGEL HOME CARE
Entity Type:Organization
Organization Name:GOLDEN ANGEL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-689-3086
Mailing Address - Street 1:7369 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-1063
Mailing Address - Country:US
Mailing Address - Phone:412-689-3086
Mailing Address - Fax:
Practice Address - Street 1:7369 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-1063
Practice Address - Country:US
Practice Address - Phone:412-689-3086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13033601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health