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General NPI Number Information
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NPI Number | 1831396746
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTH ENTERPRISES
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 400 SHEFFIELD CTR PHARMACY
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City | LORAIN
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State | OH
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Zip | 44055-3158
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Country | US
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Telephone | 216-224-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 400 SHEFFIELD CTR
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City | LORAIN
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State | OH
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Zip | 44055-3158
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Country | US
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Telephone | 216-224-3575
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. BALTEK SINGH RANDHAWA
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Credential | PHARMACIST
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Telephone | 216-224-3575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-3-23974
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License Number State | OH
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