Healthcare Provider Details

I. General information

NPI: 1477980043
Provider Name (Legal Business Name): GUARDIAN HEALTH NETWORK CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 CANAL ST 2ND FLOOR
SALEM MA
01970-4673
US

IV. Provider business mailing address

142 CANAL ST 2ND FLOOR
SALEM MA
01970-4673
US

V. Phone/Fax

Practice location:
  • Phone: 781-654-7544
  • Fax:
Mailing address:
  • Phone: 781-654-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS TERRY KARUOYA
Title or Position: CEO
Credential:
Phone: 978-406-1083