Provider Demographics
NPI:1942567789
Name:ANGELS TRANSPORTATION SERVICES, LLC
Entity type:Organization
Organization Name:ANGELS TRANSPORTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:MS/HRM
Authorized Official - Phone:614-745-0155
Mailing Address - Street 1:251 S HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2025
Mailing Address - Country:US
Mailing Address - Phone:614-745-0155
Mailing Address - Fax:614-745-1086
Practice Address - Street 1:251 S HAMILTON RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2025
Practice Address - Country:US
Practice Address - Phone:614-745-0155
Practice Address - Fax:614-745-1086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRR114725343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3062199Medicaid