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General NPI Number Information
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NPI Number | 1609213743
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Entity Type | Organization
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Legal Business Name | GUARDIANEMS
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 115 NORTH 3RD. ST.
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City | GLENWOOD
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State | AR
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Zip | 71943-9247
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Country | US
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Telephone | 870-356-2010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1233
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City | GLENWOOD
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State | AR
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Zip | 71943-1233
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Country | US
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Telephone | 870-356-2010
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | RYAN NEAL PATE
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Credential | PARAMEDIC
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Telephone | 870-557-4429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 807
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License Number State | AR
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