Provider Demographics
NPI:1770168734
Name:WINGS OF ANGELS TRANSPORTATION
Entity type:Organization
Organization Name:WINGS OF ANGELS TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LANNETT
Authorized Official - Last Name:DUFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:OWER
Authorized Official - Phone:336-307-6645
Mailing Address - Street 1:2462 WILLARD RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9127
Mailing Address - Country:US
Mailing Address - Phone:336-307-6645
Mailing Address - Fax:
Practice Address - Street 1:2462 WILLARD RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-9127
Practice Address - Country:US
Practice Address - Phone:336-307-6645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)