Healthcare Provider Details

I. General information

NPI: 1245572080
Provider Name (Legal Business Name): GUARDIAN TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9567 S MISTY OAKS CIR
SOUTH JORDAN UT
84095-3303
US

IV. Provider business mailing address

9567 S MISTY OAKS CIR
SOUTH JORDAN UT
84095-3303
US

V. Phone/Fax

Practice location:
  • Phone: 385-212-2002
  • Fax: 385-212-2003
Mailing address:
  • Phone: 385-212-2002
  • Fax: 385-212-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. ALTON HENRY GILES
Title or Position: OWNER
Credential:
Phone: 385-212-2002