Provider Demographics
NPI:1821562109
Name:ANGEL HEART TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:ANGEL HEART TRANSPORTATION, LLC
Other - Org Name:ANGEL HEART TRANSPORTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:ALSHAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-650-8221
Mailing Address - Street 1:2210 E LASALLE ST
Mailing Address - Street 2:STE 214
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-0000
Mailing Address - Country:US
Mailing Address - Phone:719-650-8221
Mailing Address - Fax:
Practice Address - Street 1:2210 E LASALLE ST
Practice Address - Street 2:STE 214
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-0000
Practice Address - Country:US
Practice Address - Phone:719-650-8221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-19
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker