MEDICARE: ANGEL WAY ENTERPRISES 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
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1326999855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL WAY ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	45 SLOAN RD NE
Second Line	:
City	:	LELAND
State	:	NC
Zip	:	28451-7341
Country	:	US
Telephone Number	:	910-232-3055
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 SLOAN RD NE
Second Line	:
City	:	LELAND
State	:	NC
Zip	:	28451-7341
Country	:	US
Telephone Number	:	910-232-3055
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KIYA MOORE
Credential	:
Telephone Number	:	910-232-3055

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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