Healthcare Provider Details

I. General information

NPI: 1053734996
Provider Name (Legal Business Name): ANGEL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 MEDICAL PARK DR SUITE 302
FRANKLIN NC
28734-2632
US

IV. Provider business mailing address

PO BOX 1209
FRANKLIN NC
28744-0569
US

V. Phone/Fax

Practice location:
  • Phone: 828-369-1300
  • Fax: 828-369-1400
Mailing address:
  • Phone: 828-369-1300
  • Fax: 828-369-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JIM BROSS
Title or Position: PRESIDENT
Credential:
Phone: 828-369-4231