Healthcare Provider Details

I. General information

NPI: 1437610581
Provider Name (Legal Business Name): AINSLEY'S ANGELS OF AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 CABRINI PLACE
VIRGINIA BEACH VA
23464
US

IV. Provider business mailing address

PO BOX 6287
VIRGINIA BEACH VA
23456
US

V. Phone/Fax

Practice location:
  • Phone: 757-202-7915
  • Fax:
Mailing address:
  • Phone: 757-202-7915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KIM R ROSSITER
Title or Position: PRESIDENT
Credential:
Phone: 757-202-7915