Provider Demographics
NPI:1548505225
Name:ANNIE'S ANGLES
Entity type:Organization
Organization Name:ANNIE'S ANGLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-446-8871
Mailing Address - Street 1:408 E BUTLER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-3249
Mailing Address - Country:US
Mailing Address - Phone:864-335-8224
Mailing Address - Fax:
Practice Address - Street 1:408 E BUTLER RD
Practice Address - Street 2:SUITE C
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-3249
Practice Address - Country:US
Practice Address - Phone:864-335-8224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care