Provider Demographics
NPI:1265296503
Name:CAMILLE'S ANGELS LLC
Entity type:Organization
Organization Name:CAMILLE'S ANGELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-228-4301
Mailing Address - Street 1:1633 GUTHRIE ST
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6706
Mailing Address - Country:US
Mailing Address - Phone:757-228-4301
Mailing Address - Fax:
Practice Address - Street 1:1633 GUTHRIE ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6706
Practice Address - Country:US
Practice Address - Phone:757-629-4421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)