Provider Demographics
NPI:1699306829
Name:ANGELS HEART MEDICAL TRANSPORTATION LLC
Entity type:Organization
Organization Name:ANGELS HEART MEDICAL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:RAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-558-9019
Mailing Address - Street 1:1129 SILVER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PAVILION
Mailing Address - State:NY
Mailing Address - Zip Code:14525-9517
Mailing Address - Country:US
Mailing Address - Phone:585-558-9019
Mailing Address - Fax:
Practice Address - Street 1:1129 SILVER LAKE RD
Practice Address - Street 2:
Practice Address - City:PAVILION
Practice Address - State:NY
Practice Address - Zip Code:14525-9517
Practice Address - Country:US
Practice Address - Phone:585-558-9019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)