Healthcare Provider Details

I. General information

NPI: 1073744884
Provider Name (Legal Business Name): ANGELCARE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5180 JIMMY CARTER BLVD
NORCROSS GA
30093-1618
US

IV. Provider business mailing address

5180 JIMMY CARTER BLVD
NORCROSS GA
30093-1618
US

V. Phone/Fax

Practice location:
  • Phone: 770-446-1555
  • Fax: 678-646-1969
Mailing address:
  • Phone: 770-446-1555
  • Fax: 678-646-1969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number31963
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number31963
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number31963
License Number StateGA

VIII. Authorized Official

Name: DR. JAMES ALBERT PRITCHARD III
Title or Position: PRESIDENT
Credential:
Phone: 770-446-1555