Provider Demographics
NPI:1073783775
Name:GUARDIAN BUSINESS GROUP
Entity Type:Organization
Organization Name:GUARDIAN BUSINESS GROUP
Other - Org Name:DBA AIDC MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:PELFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-695-5177
Mailing Address - Street 1:519 E HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:815-695-5177
Mailing Address - Fax:815-695-5102
Practice Address - Street 1:3742 E 29TH RD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:IL
Practice Address - Zip Code:61360
Practice Address - Country:US
Practice Address - Phone:815-695-5177
Practice Address - Fax:815-695-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies