Provider Demographics
NPI:1093053126
Name:GUARDIAN HEALTH SYSTEMS AURORA
Entity Type:Organization
Organization Name:GUARDIAN HEALTH SYSTEMS AURORA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:R
Authorized Official - Last Name:MUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-8181
Mailing Address - Street 1:7920 ELMBROOK DRIVE SUITE 108
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247
Mailing Address - Country:US
Mailing Address - Phone:214-221-8181
Mailing Address - Fax:
Practice Address - Street 1:7920 ELMBROOK DRIVE SUITE 108
Practice Address - Street 2:SUITE 108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247
Practice Address - Country:US
Practice Address - Phone:214-221-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy