Provider Demographics
NPI:1710601745
Name:BLUEEYE ANGELS LLC
Entity Type:Organization
Organization Name:BLUEEYE ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DURGA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGINENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-409-0502
Mailing Address - Street 1:2001 71ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501
Mailing Address - Country:US
Mailing Address - Phone:425-409-0502
Mailing Address - Fax:
Practice Address - Street 1:2001 71ST AVE SE
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:425-409-0502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care