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General NPI Number Information
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NPI Number | 1932244233
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Entity Type | Organization
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Legal Business Name | ANGEL TRANSPORTATION
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 245 W RED OAK DR APT 2
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City | MEMPHIS
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State | TN
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Zip | 38112-4655
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Country | US
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Telephone | 901-644-4324
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Fax |
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Provider Business Mailing Address
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Address Line | 245 W RED OAK DR APT 2
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City | MEMPHIS
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State | TN
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Zip | 38112-4655
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Country | US
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Telephone | 901-644-4324
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE MASON
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Credential |
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Telephone | 901-644-4324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 70966182
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License Number State | TN
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