Provider Demographics
NPI:1801362645
Name:EARTH ANGEL SERVICES, LLC
Entity Type:Organization
Organization Name:EARTH ANGEL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANTZ
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERNADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-306-3857
Mailing Address - Street 1:9 STONE LEIGH WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4887
Mailing Address - Country:US
Mailing Address - Phone:609-306-3857
Mailing Address - Fax:
Practice Address - Street 1:9 STONE LEIGH WAY
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4887
Practice Address - Country:US
Practice Address - Phone:609-306-3857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)