MEDICARE: ANGEL 44 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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1912715301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL 44 CARE LLC

Provider Business Mailing Address
First Line	:	4707 W PALMAIRE AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2723
Country	:	US
Telephone Number	:	480-388-4935
Fax Number	:

Provider Business Practice Location Address
First Line	:	4707 W PALMAIRE AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2723
Country	:	US
Telephone Number	:	480-388-4935
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. FATUMA AHMED
Credential	:
Telephone Number	:	480-388-4935

Provider Enumeration Date	:	12/18/2024
Last Update Date	:	12/18/2024

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