Provider Demographics
NPI:1609213743
Name:GUARDIANEMS
Entity Type:Organization
Organization Name:GUARDIANEMS
Other - Org Name:EMERGENCY MEDICAL TRANSPORT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:PATE
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:870-557-4429
Mailing Address - Street 1:PO BOX 1233
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:71943-1233
Mailing Address - Country:US
Mailing Address - Phone:870-356-2010
Mailing Address - Fax:
Practice Address - Street 1:115 NORTH 3RD. ST.
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:AR
Practice Address - Zip Code:71943-9247
Practice Address - Country:US
Practice Address - Phone:870-356-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR807341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance