Provider Demographics
NPI:1114146651
Name:GUARDIAN MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:GUARDIAN MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVED
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-395-0590
Mailing Address - Street 1:29500 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2030
Mailing Address - Country:US
Mailing Address - Phone:248-395-0590
Mailing Address - Fax:248-395-0591
Practice Address - Street 1:29500 SOUTHFIELD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2030
Practice Address - Country:US
Practice Address - Phone:248-395-0590
Practice Address - Fax:248-395-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5910410001Medicare NSC