Provider Demographics
NPI:1669684338
Name:ANGELS MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:ANGELS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT TREASURE
Authorized Official - Prefix:MS
Authorized Official - First Name:ELBA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-777-9090
Mailing Address - Street 1:PO BOX 503027
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00805-3027
Mailing Address - Country:US
Mailing Address - Phone:340-777-9090
Mailing Address - Fax:340-714-4493
Practice Address - Street 1:FOUR WIND PLAZA
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-777-9090
Practice Address - Fax:340-714-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-2027504-2007332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1174710001Medicare NSC