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General NPI Number Information
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NPI Number | 1356534093
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTHCARE, INC.
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 2317 WESTWOOD AVE SUITE 208
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City | RICHMOND
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State | VA
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Zip | 23230-4007
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Country | US
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Telephone | 804-306-5430
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Fax | 804-340-2836
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Provider Business Mailing Address
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Address Line | 2317 WESTWOOD AVE SUITE 208
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City | RICHMOND
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State | VA
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Zip | 23230-4007
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Country | US
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Telephone | 804-306-5430
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Fax | 804-340-2836
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Authorized Official
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Title or Position | OWNER
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Name | MR. LENNY EUGENE FLOOD
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Credential | RRT
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Telephone | 804-306-5430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0117001432
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License Number State | VA
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