Provider Demographics
NPI:1679287460
Name:ANGELS CARE TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ANGELS CARE TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-791-0134
Mailing Address - Street 1:PO BOX 653
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-0653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1526 S. 92
Practice Address - Street 2:4
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-4368
Practice Address - Country:US
Practice Address - Phone:920-791-0134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker