Provider Demographics
NPI:1235690421
Name:GUARDIAN ANGELS MEDICAL SUPPLY
Entity Type:Organization
Organization Name:GUARDIAN ANGELS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:EXPOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-406-1129
Mailing Address - Street 1:5865 JIMMY CARTER BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2921
Mailing Address - Country:US
Mailing Address - Phone:404-406-1129
Mailing Address - Fax:888-247-2519
Practice Address - Street 1:11785 NORTHFALL LN STE 512
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7967
Practice Address - Country:US
Practice Address - Phone:404-406-1129
Practice Address - Fax:888-247-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies