MEDICARE: ANGELS PHH CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	008758	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	60P8877	OTHER	TX	MDCP UCN NUMBER

General Provider Information

NPI Number	:	1003842451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGELS PHH CORP

Provider Business Mailing Address
First Line	:	PO BOX 338
Second Line	:
City	:	HOWE
State	:	TX
Zip	:	75459
Country	:	US
Telephone Number	:	903-532-1400
Fax Number	:	903-532-1401

Provider Business Practice Location Address
First Line	:	102 S COLLINS FRWY
Second Line	:
City	:	HOWE
State	:	TX
Zip	:	75459
Country	:	US
Telephone Number	:	903-532-1400
Fax Number	:	903-532-1401

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. BONNIE MARIE WEST
Credential	:	LVN
Telephone Number	:	903-532-1400

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	08/22/2020

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Directions to “ANGELS PHH CORP ” Practice Location

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