Healthcare Provider Details

I. General information

NPI: 1255309415
Provider Name (Legal Business Name): ANGEL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 RIVERVIEW STREET
FRANKLIN NC
28734-2634
US

IV. Provider business mailing address

PO BOX 1209
FRANKLIN NC
28744-0569
US

V. Phone/Fax

Practice location:
  • Phone: 828-524-8411
  • Fax: 828-524-2712
Mailing address:
  • Phone: 828-213-1500
  • Fax: 828-651-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: MS. RHONDA ARLENE MILLER
Title or Position: VP
Credential:
Phone: 828-651-4152