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General NPI Number Information
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NPI Number | 1073752440
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Entity Type | Organization
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Legal Business Name | GUARDIAN CRITICAL CARE SERVICES LLC
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 1900 GARNET COURT
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City | NEW LENOX
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State | IL
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Zip | 60451
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Country | US
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Telephone | 224-699-9188
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 129
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City | NEW LENOX
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State | IL
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Zip | 60451
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Country | US
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Telephone | 224-699-9188
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. MICHAEL S DERMONT
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Credential |
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Telephone | 224-699-9188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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