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Contact Information

ANGUS LAKE HEALTHCARE, LLC
242 MILLEDGEVILLE HWY
GORDON, GA31031-3827
 Phone: 229-520-5151
 Fax: 478-628-2263
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for ANGUS LAKE HEALTHCARE, LLC

NPI Number 1912340829
LBN Legal business name ANGUS LAKE HEALTHCARE, LLC
Authorized official CARL STANLEY - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/10/2013
Last updated 05/04/2017 - About 9 years ago
Identifiers
GA License # PHRE009911
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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