Provider Demographics
NPI:1033748397
Name:GUARDIAN ADVANTAGE LLC
Entity Type:Organization
Organization Name:GUARDIAN ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-379-5050
Mailing Address - Street 1:2089 EXCHANGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5988
Mailing Address - Country:US
Mailing Address - Phone:636-379-5050
Mailing Address - Fax:636-648-5099
Practice Address - Street 1:2089 EXCHANGE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5988
Practice Address - Country:US
Practice Address - Phone:636-379-5050
Practice Address - Fax:636-648-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No341600000XTransportation ServicesAmbulance