MEDICARE: AN ANGELS TOUCH 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)	03157629000	NM
2	253Z00000X	In Home Supportive Care Agency	03157629000	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780817668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AN ANGELS TOUCH LLC

Provider Business Mailing Address
First Line	:	146 BRIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3427
Country	:	US
Telephone Number	:	505-454-1595
Fax Number	:	505-454-1510

Provider Business Practice Location Address
First Line	:	146 BRIDGE ST
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-3427
Country	:	US
Telephone Number	:	505-454-1595
Fax Number	:	505-454-1510

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MR. PHILLIP CHARLES WARFIELD
Credential	:
Telephone Number	:	505-454-1595

Provider Enumeration Date	:	08/26/2009
Last Update Date	:	08/26/2009

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