Healthcare Provider Details

I. General information

NPI: 1609312305
Provider Name (Legal Business Name): GUARDIAN ANGEL HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 11/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5969 E LIVINGSTON AVE STE 112
COLUMBUS OH
43232-2907
US

IV. Provider business mailing address

5600 KENNY DR
ZANESVILLE OH
43701-9396
US

V. Phone/Fax

Practice location:
  • Phone: 614-868-3225
  • Fax: 614-868-3437
Mailing address:
  • Phone: 614-316-7421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. THOMAS M KAMAU
Title or Position: CEO
Credential: PH.D
Phone: 614-316-7421