Provider Demographics
NPI:1912045980
Name:GUARDIAN ANGEL HEALTH CARE SOLUTIONS,LLC
Entity Type:Organization
Organization Name:GUARDIAN ANGEL HEALTH CARE SOLUTIONS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-342-6435
Mailing Address - Street 1:295 N KERRWOOD DR
Mailing Address - Street 2:ARBOR SUITE # 105
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5207
Mailing Address - Country:US
Mailing Address - Phone:724-342-6434
Mailing Address - Fax:724-342-6305
Practice Address - Street 1:295 N KERRWOOD DR
Practice Address - Street 2:ARBOR SUITE # 105
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5207
Practice Address - Country:US
Practice Address - Phone:724-342-6435
Practice Address - Fax:724-342-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA77870501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1006366350003Medicaid
PA397787Medicare Oscar/Certification