MEDICARE: GUARDIANS ON CALL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548879869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIANS ON CALL LLC

Provider Business Mailing Address
First Line	:	1244 WHISPERING WOODS DR
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-4627
Country	:	US
Telephone Number	:	215-292-9545
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 LANSING ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3504
Country	:	US
Telephone Number	:	215-292-9545
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMIRA WILMORE
Credential	:
Telephone Number	:	215-292-9545

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	07/23/2020

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