MEDICARE: GUARDIAN ADLITIEM HEALTH SERVICES, 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
1	251E00000X	Home Health Agency	LCB20110000312	GA

General Provider Information

NPI Number	:	1629376868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN ADLITIEM HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	3350 PEACH ORCHARD RD STE 807
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30906-5932
Country	:	US
Telephone Number	:	706-664-8373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 PEACH ORCHARD RD STE 807
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30906-5932
Country	:	US
Telephone Number	:	706-664-8373
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LINDA J CURRY
Credential	:	REGISTERED NURSE
Telephone Number	:	706-664-7383

Provider Enumeration Date	:	03/12/2011
Last Update Date	:	03/12/2011

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