Organization
HEAVENS ANGEL HOMECARE AGENCY
Active
Parent organization
HEAVENS ANGEL HOMECARE AGENCY
Other names
Heavens Angel Homecare Agency
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEAVENS ANGEL HOMECARE AGENCY
Authorized official
TONYA CHEEKS (OWNER)
(864) 787-7492
Entity
Organization
Contact information
Practice address
20 S POINSETT HWY STE I, TRAVELERS RST, SC 29690-1857
(864) 787-7492
Mailing address
109 MIDWOOD RD, TRAVELERS RST, SC 29690-1865
(864) 787-7492
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1721
—
SC
Enumeration date
10/30/2019
Last updated
10/30/2019
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