MEDICARE: GUARDIAN ANGEL AMBULANCE SERVICES, 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	3416L0300X	Land Ambulance		PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649260019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN ANGEL AMBULANCE SERVICES, INC.

Provider Business Mailing Address
First Line	:	411 W 8TH AVE
Second Line	:	PO BOX 435
City	:	WEST HOMESTEAD
State	:	PA
Zip	:	15120-1014
Country	:	US
Telephone Number	:	412-464-1000
Fax Number	:	412-462-9947

Provider Business Practice Location Address
First Line	:	411 W 8TH AVE
Second Line	:
City	:	WEST HOMESTEAD
State	:	PA
Zip	:	15120-1014
Country	:	US
Telephone Number	:	412-464-1000
Fax Number	:	412-462-9947

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN J MCAFEE
Credential	:	EMT
Telephone Number	:	412-464-1000

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/20/2009

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