Healthcare Provider Details

I. General information

NPI: 1619383635
Provider Name (Legal Business Name): ANGEL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 RIVERVIEW ST
FRANKLIN NC
28734-2612
US

IV. Provider business mailing address

PO BOX 1209
FRANKLIN NC
28744-0569
US

V. Phone/Fax

Practice location:
  • Phone: 828-349-6800
  • Fax: 828-349-6810
Mailing address:
  • Phone: 828-349-6800
  • Fax: 828-349-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAMES BROSS
Title or Position: CEO
Credential:
Phone: 828-369-4231