Provider Demographics
NPI:1790465060
Name:ANGEL CARE PHARMACY LLC
Entity Type:Organization
Organization Name:ANGEL CARE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TCHANQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-708-3858
Mailing Address - Street 1:7223A RISING SUN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3926
Mailing Address - Country:US
Mailing Address - Phone:610-708-3858
Mailing Address - Fax:610-708-3859
Practice Address - Street 1:7223A RISING SUN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-3926
Practice Address - Country:US
Practice Address - Phone:610-708-3858
Practice Address - Fax:610-708-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy