Provider Demographics
NPI:1952746323
Name:RENEWED SPIRIT LLC
Entity Type:Organization
Organization Name:RENEWED SPIRIT LLC
Other - Org Name:GUARDIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-747-6371
Mailing Address - Street 1:6502 BLUFFTON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46809-2370
Mailing Address - Country:US
Mailing Address - Phone:260-747-6371
Mailing Address - Fax:260-747-1818
Practice Address - Street 1:6502 BLUFFTON RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46809-2370
Practice Address - Country:US
Practice Address - Phone:260-747-6371
Practice Address - Fax:260-747-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment