MEDICARE: GUARDIAN HEALTHCARE, INC.

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
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0117001432	VA

General Provider Information

NPI Number	:	1356534093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	2317 WESTWOOD AVE
Second Line	:	SUITE 208
City	:	RICHMOND
State	:	VA
Zip	:	23230-4007
Country	:	US
Telephone Number	:	804-306-5430
Fax Number	:	804-340-2836

Provider Business Practice Location Address
First Line	:	2317 WESTWOOD AVE
Second Line	:	SUITE 208
City	:	RICHMOND
State	:	VA
Zip	:	23230-4007
Country	:	US
Telephone Number	:	804-306-5430
Fax Number	:	804-340-2836

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LENNY EUGENE FLOOD
Credential	:	RRT
Telephone Number	:	804-306-5430

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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