Healthcare Provider Details

I. General information

NPI: 1710430822
Provider Name (Legal Business Name): ANGEL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 DEPOT ST
FRANKLIN NC
28734-0176
US

IV. Provider business mailing address

PO BOX 602706
CHARLOTTE NC
28260-2706
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-4262
  • Fax:
Mailing address:
  • Phone: 828-253-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RHONDA A MILLER
Title or Position: VP-CBO
Credential:
Phone: 828-651-4144