MEDICARE: BLUE ANGELS CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse

General Provider Information

NPI Number	:	1548096340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE ANGELS CARE LLC

Provider Business Mailing Address
First Line	:	201 E PLANK RD
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-4109
Country	:	US
Telephone Number	:	814-600-2313
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 E PLANK RD
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-4109
Country	:	US
Telephone Number	:	814-600-2313
Fax Number	:

Authorized Official
Title or Position	:	CEO, CO-OWNER
Name	:	DUONG CHAU
Credential	:
Telephone Number	:	814-600-2313

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	03/10/2026

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