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NPI Code Detail

MEDICARE: ANGEL WING CARE TRANSIT LLC

MEDICARE: ANGEL WING CARE TRANSIT LLC
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
1347C00000XPrivate Vehicle

General Provider Information

NPI Number : 1174168231
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGEL WING CARE TRANSIT LLC
Provider Business Mailing Address
First Line : 4330 OLD VIRGINIA ST NE
Second Line :
City : ROANOKE
State : VA
Zip : 24019-5750
Country : US
Telephone Number : 540-293-9366
Fax Number :
Provider Business Practice Location Address
First Line : 4330 OLD VIRGINIA ST NE
Second Line :
City : ROANOKE
State : VA
Zip : 24019-5750
Country : US
Telephone Number : 540-293-9366
Fax Number :
Authorized Official
Title or Position : MANGER
Name : ZAINAB SALAH AL-BAGHDADI
Credential :
Telephone Number : 540-293-9366
Provider Enumeration Date : 11/13/2019
Last Update Date : 11/29/2019

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Directions to “ANGEL WING CARE TRANSIT LLC ” Practice Location

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