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General NPI Number Information
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NPI Number | 1407110950
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTHCARE NEWCO, LLC
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Dates
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Enumeration Date | 06/29/2012
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Last Update Date | 06/29/2012
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Provider Practice Location Address
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Address Line | 7265 KENWOOD RD SUITE A
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City | CINCINNATI
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State | OH
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Zip | 45236-4400
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Country | US
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Telephone | 513-842-1101
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Fax | 513-842-1105
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Provider Business Mailing Address
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Address Line | 1575 HERITAGE DR SUITE 201
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 214-491-4711
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Fax | 214-491-4047
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Authorized Official
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Title or Position | CFO
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Name | MR. DOUG CANNON
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Credential |
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Telephone | 214-491-4711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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