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NPI Code Detail

MEDICARE: GUARDIAN DME, LLC

MEDICARE: GUARDIAN DME, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesPT012778LPA

General Provider Information

NPI Number : 1083866396
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN DME, LLC
Provider Business Mailing Address
First Line : 2127 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-3216
Country : US
Telephone Number : 215-742-8099
Fax Number : 215-742-1871
Provider Business Practice Location Address
First Line : 2127 RHAWN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-3216
Country : US
Telephone Number : 215-742-8099
Fax Number : 215-742-1871
Authorized Official
Title or Position : OWNER/PHYSICAL THERAPIST
Name : MR. MICHAEL BEAUDOIN
Credential : MPT
Telephone Number : 215-742-8099
Provider Enumeration Date : 10/17/2008
Last Update Date : 11/19/2008

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2127 RHAWN ST
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1689784217 — ADVANCED PHYSICAL THERAPY
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1063086403 — DAVID MALONE
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PHILADELPHIA, PA
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1104600519 — COLLEEN PLOTCHER PTA
Practice Location Address:
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19152-3216
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Directions to “GUARDIAN DME, LLC ” Practice Location

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