Provider Demographics
NPI:1982747176
Name:ANGELIC CARE
Entity Type:Organization
Organization Name:ANGELIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-634-6200
Mailing Address - Street 1:1 COLTON CT
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-2145
Mailing Address - Country:US
Mailing Address - Phone:732-634-6200
Mailing Address - Fax:732-634-6201
Practice Address - Street 1:1 COLTON CT
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-2145
Practice Address - Country:US
Practice Address - Phone:732-634-6200
Practice Address - Fax:732-634-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4339310001Medicare NSC