Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Parenteral & Enteral Nutrition |
332BP3500X | 87 | All Other Suppliers |
| NPI # | 1811531015 |
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| LBN Legal business name | HEAVENS ANGEL HOMECARE AGENCY | ||||
| Authorized official | TONYA CHEEKS - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 10/30/2019 | ||||
| Last updated | 10/30/2019 - About 7 years ago | ||||
| Identifiers |
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