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General NPI Number Information
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NPI Number | 1093052706
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Entity Type | Organization
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Legal Business Name | GUARDIAN ANGEL'S MEDICAL SUPPLY,INC.
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 222 I ST SUITE B
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City | LOS BANOS
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State | CA
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Zip | 93635-4132
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Country | US
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Telephone | 209-826-2223
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Fax | 209-826-2242
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Provider Business Mailing Address
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Address Line | 222 I ST SUITE B
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City | LOS BANOS
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State | CA
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Zip | 93635-4132
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Country | US
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Telephone | 209-826-2223
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Fax | 209-826-2242
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Authorized Official
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Title or Position | OWNER/CHIEF EXECUTIVE OFFICER
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Name | DEBBIE DIANE PERRY
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Credential | R.N.
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Telephone | 209-489-9109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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