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General NPI Number Information
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NPI Number | 1093053126
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTH SYSTEMS AURORA
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 7920 ELMBROOK DRIVE SUITE 108 SUITE 108
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City | DALLAS
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State | TX
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Zip | 75247
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Country | US
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Telephone | 214-221-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 7920 ELMBROOK DRIVE SUITE 108 SUITE 108
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City | DALLAS
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State | TX
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Zip | 75247
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Country | US
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Telephone | 214-221-8181
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Fax |
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Authorized Official
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Title or Position | RPH/OWNER
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Name | JACK R MUNN
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Credential |
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Telephone | 214-221-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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