Provider Demographics
NPI:1265691877
Name:ANGELS IN YOUR CORNER
Entity type:Organization
Organization Name:ANGELS IN YOUR CORNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOELSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-345-1551
Mailing Address - Street 1:1524 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-3708
Mailing Address - Country:US
Mailing Address - Phone:208-345-1551
Mailing Address - Fax:208-345-6254
Practice Address - Street 1:1524 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-3708
Practice Address - Country:US
Practice Address - Phone:208-345-1551
Practice Address - Fax:208-345-6254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID6343150001Medicare NSC