Provider Demographics
NPI:1285342253
Name:ANGELS ON WHEELS TRANSPORTATION
Entity type:Organization
Organization Name:ANGELS ON WHEELS TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF
Authorized Official - Prefix:
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:DONITA
Authorized Official - Last Name:DAUGHTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-967-0374
Mailing Address - Street 1:131 BALSAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-8562
Mailing Address - Country:US
Mailing Address - Phone:910-967-0374
Mailing Address - Fax:
Practice Address - Street 1:131 BALSAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-8562
Practice Address - Country:US
Practice Address - Phone:910-967-0374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle