MEDICARE: GUARDIAN MEDICAL TRANSPORT 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

General Provider Information

NPI Number	:	1790110658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN MEDICAL TRANSPORT INC

Provider Business Mailing Address
First Line	:	5713 N AMERICAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2365
Country	:	US
Telephone Number	:	267-345-3661
Fax Number	:	973-224-1200

Provider Business Practice Location Address
First Line	:	5713 N AMERICAN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19120-2365
Country	:	US
Telephone Number	:	267-345-3661
Fax Number	:	215-224-1200

Authorized Official
Title or Position	:	CEO
Name	:	MR. MATTHEW MAY
Credential	:
Telephone Number	:	267-345-3661

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	12/05/2013

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Directions to “GUARDIAN MEDICAL TRANSPORT INC ” Practice Location

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