Healthcare Provider Details

I. General information

NPI: 1407916117
Provider Name (Legal Business Name): GUARDIAN ANGELS HOME HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 S GEORGE ST
FARMVILLE NC
27828-1897
US

IV. Provider business mailing address

3637 S GEORGE ST
FARMVILLE NC
27828-1897
US

V. Phone/Fax

Practice location:
  • Phone: 252-753-3500
  • Fax:
Mailing address:
  • Phone: 252-753-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM CHAVIS FIELDS
Title or Position: DIRECTOR
Credential:
Phone: 252-753-3500