Provider Demographics
NPI:1831396746
Name:GUARDIAN HEALTH ENTERPRISES
Entity type:Organization
Organization Name:GUARDIAN HEALTH ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BALTEK
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:216-224-3575
Mailing Address - Street 1:400 SHEFFIELD CTR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3158
Mailing Address - Country:US
Mailing Address - Phone:216-224-3575
Mailing Address - Fax:
Practice Address - Street 1:400 SHEFFIELD CTR
Practice Address - Street 2:PHARMACY
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3158
Practice Address - Country:US
Practice Address - Phone:216-224-3575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-23974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty