Provider Demographics
NPI:1972596625
Name:GUARDIAN HEALTH CARE INC.
Entity Type:Organization
Organization Name:GUARDIAN HEALTH CARE INC.
Other - Org Name:GUARDIAN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO EVP
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3516
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:225-299-3253
Mailing Address - Fax:
Practice Address - Street 1:1320 S UNIVERSITY DR STE 220
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5743
Practice Address - Country:US
Practice Address - Phone:817-882-8200
Practice Address - Fax:817-882-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001871251E00000X
TX011216251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024492301Medicaid
677125Medicare Oscar/Certification