Provider Demographics
NPI:1699227835
Name:ANGEL CARE TRANSPORT LLC
Entity Type:Organization
Organization Name:ANGEL CARE TRANSPORT LLC
Other - Org Name:ANGEL CARE TRANSPORT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JENWEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-831-3754
Mailing Address - Street 1:804 E HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3645
Mailing Address - Country:US
Mailing Address - Phone:909-757-9551
Mailing Address - Fax:
Practice Address - Street 1:804 E HIGH AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-3645
Practice Address - Country:US
Practice Address - Phone:909-757-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)