Provider Demographics
NPI:1265814602
Name:GUARDIAN ANGEL TRANSPORTATION LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGEL TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-324-4100
Mailing Address - Street 1:2676 GRIT RD
Mailing Address - Street 2:
Mailing Address - City:HURT
Mailing Address - State:VA
Mailing Address - Zip Code:24563-3348
Mailing Address - Country:US
Mailing Address - Phone:434-324-4100
Mailing Address - Fax:434-324-4700
Practice Address - Street 1:2676 GRIT RD
Practice Address - Street 2:
Practice Address - City:HURT
Practice Address - State:VA
Practice Address - Zip Code:24563-3348
Practice Address - Country:US
Practice Address - Phone:434-324-4100
Practice Address - Fax:434-324-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA237343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)