Provider Demographics
NPI:1902129711
Name:ANGELS ON CALL HEALTHCARE,LLP
Entity Type:Organization
Organization Name:ANGELS ON CALL HEALTHCARE,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-536-3242
Mailing Address - Street 1:181 E EVANS ST STE E-2
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2511
Mailing Address - Country:US
Mailing Address - Phone:843-536-3242
Mailing Address - Fax:843-536-3242
Practice Address - Street 1:181 E EVANS ST STE E-2
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2511
Practice Address - Country:US
Practice Address - Phone:843-536-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X-HOME HEAL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1016Medicaid