Provider Demographics
NPI:1902613284
Name:GUARDIAN DME LLC
Entity type:Organization
Organization Name:GUARDIAN DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GEVORG
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-728-0019
Mailing Address - Street 1:1750 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-728-0019
Mailing Address - Fax:702-447-8969
Practice Address - Street 1:1750 S RAINBOW BLVD
Practice Address - Street 2:SUITE 20
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-2951
Practice Address - Country:US
Practice Address - Phone:702-728-0019
Practice Address - Fax:702-447-9276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies