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Organization
GUARDIAN PHARMACY OF TULSA, LLC
Active
Organization
GUARDIAN PHARMACY OF TULSA, LLC
Active
Other names
Boomer Solutions of Tulsa
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY BURGESS (PRESIDENT)
(866) 237-8217
Entity
Organization
Contact information
Practice address
5415 S 125TH EAST AVE, SUITE 201-203, TULSA, OK 74146-6232
(866) 237-8217
(855) 711-3900
Mailing address
PO BOX 11407, DEPT # 2610, BIRMINGHAM, AL 35246-2610
(404) 810-0089
(404) 810-0094
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
2-7811
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200611770C
—
OK
Enumeration date
02/26/2016
Last updated
02/24/2017
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