Provider Demographics
NPI:1811932676
Name:GUARDIAN AMBULANCE
Entity type:Organization
Organization Name:GUARDIAN AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-590-7646
Mailing Address - Street 1:PO BOX 680395
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78268-0395
Mailing Address - Country:US
Mailing Address - Phone:210-590-7646
Mailing Address - Fax:210-520-0273
Practice Address - Street 1:10123 WOODTRAIL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-3374
Practice Address - Country:US
Practice Address - Phone:210-590-7646
Practice Address - Fax:210-520-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015095341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAMB143Medicare ID - Type UnspecifiedPROVIDER ID