Provider Demographics
NPI:1396159166
Name:MA'S ANGELS WINGS INC.
Entity type:Organization
Organization Name:MA'S ANGELS WINGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ABRAMCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:814-881-3647
Mailing Address - Street 1:818 STATE ST STE A
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1364
Mailing Address - Country:US
Mailing Address - Phone:814-881-3647
Mailing Address - Fax:626-672-3626
Practice Address - Street 1:2741 E 29TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510-2825
Practice Address - Country:US
Practice Address - Phone:814-881-3647
Practice Address - Fax:626-672-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care