Provider Demographics
NPI:1184726242
Name:GUARDIAN MEDICAL MONITORING, LLC
Entity type:Organization
Organization Name:GUARDIAN MEDICAL MONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-206-2954
Mailing Address - Street 1:3000 TOWN CTR STE 2555
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1144
Mailing Address - Country:US
Mailing Address - Phone:888-349-2400
Mailing Address - Fax:877-205-3621
Practice Address - Street 1:3000 TOWN CTR STE 2555
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1144
Practice Address - Country:US
Practice Address - Phone:888-349-2400
Practice Address - Fax:877-205-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2166114Medicaid
CO54105536Medicaid
ILER 16000207Medicaid
VA009110992Medicaid
DC019966900Medicaid
PA102071541 002Medicaid
TN568996Medicaid
MI3420303Medicaid
WY1184726242Medicaid
IN200264880Medicaid