Provider Demographics
NPI: | 1821121492 |
---|---|
Name: | VISTING ANGELS MEDICAL EQUIPMENT |
Entity Type: | Organization |
Organization Name: | VISTING ANGELS MEDICAL EQUIPMENT |
Other - Org Name: | VISTING ANGELS MEDICAL EQUIPMENT |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | AMANDA |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | GOMEZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 956-580-3809 |
Mailing Address - Street 1: | 1928 N CONWAY AVE |
Mailing Address - Street 2: | STE. A |
Mailing Address - City: | MISSION |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78572-2938 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 956-580-3809 |
Mailing Address - Fax: | 956-580-3802 |
Practice Address - Street 1: | 1928 N CONWAY AVE |
Practice Address - Street 2: | STE. A |
Practice Address - City: | MISSION |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78572-2938 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-580-3809 |
Practice Address - Fax: | 956-580-3802 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-03-13 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |