Provider Demographics
NPI:1861042202
Name:ANGELS ON BOARD MEDICAL TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:ANGELS ON BOARD MEDICAL TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-823-7888
Mailing Address - Street 1:604 BOGEY LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5451
Mailing Address - Country:US
Mailing Address - Phone:817-744-0137
Mailing Address - Fax:
Practice Address - Street 1:604 BOGEY LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5451
Practice Address - Country:US
Practice Address - Phone:817-823-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGELS ON BOARD HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health