Provider Demographics
NPI:1053013649
Name:GUARDIAN MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:GUARDIAN MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ONYE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ONUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-426-1653
Mailing Address - Street 1:8408 SIX FORKS RD STE 102B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3077
Mailing Address - Country:US
Mailing Address - Phone:919-229-0883
Mailing Address - Fax:919-657-9232
Practice Address - Street 1:8408 SIX FORKS RD STE 102B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3077
Practice Address - Country:US
Practice Address - Phone:919-229-0883
Practice Address - Fax:919-657-9232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies