Healthcare Provider Details

I. General information

NPI: 1578479200
Provider Name (Legal Business Name): ANGEL NURSING CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6719 ANDERS TER
SPRINGFIELD VA
22151-3704
US

IV. Provider business mailing address

6719 ANDERS TER
SPRINGFIELD VA
22151-3704
US

V. Phone/Fax

Practice location:
  • Phone: 703-946-7845
  • Fax: 703-946-7845
Mailing address:
  • Phone: 703-946-7845
  • Fax: 703-946-7845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MEDINA A OMER
Title or Position: OWNER
Credential:
Phone: 703-946-7845