Provider Demographics
NPI:1770822785
Name:ANGEL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ANGEL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-718-9286
Mailing Address - Street 1:4701 BENNING RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5173
Mailing Address - Country:US
Mailing Address - Phone:202-718-9286
Mailing Address - Fax:
Practice Address - Street 1:4701 BENNING RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5173
Practice Address - Country:US
Practice Address - Phone:202-718-9286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2649653343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)