Provider Demographics
NPI:1689442493
Name:CHARLIES ANGELS HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:CHARLIES ANGELS HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-876-2887
Mailing Address - Street 1:7004 SECURITY BLVD STE 316
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2557
Mailing Address - Country:US
Mailing Address - Phone:443-876-2887
Mailing Address - Fax:
Practice Address - Street 1:7004 SECURITY BLVD STE 316
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2557
Practice Address - Country:US
Practice Address - Phone:443-876-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care