# GUARDIAN PHARMACY OF TULSA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boomer Solutions of Tulsa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194185504
- **Authorized official:** RICKY BURGESS (PRESIDENT)
- **Authorized official phone:** (866) 237-8217

## Contact information

- **Practice address:** 5415 S 125TH EAST AVE, SUITE 201-203, TULSA, OK 74146-6232
- **Practice address phone:** (866) 237-8217
- **Practice address fax:** (855) 711-3900
- **Mailing address:** PO BOX 11407, DEPT \# 2610, BIRMINGHAM, AL 35246-2610
- **Mailing address phone:** (404) 810-0089
- **Mailing address fax:** (404) 810-0094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 2-7811 | OK | Yes |

## Other

- **Enumeration date:** 02/26/2016
- **Last updated:** 02/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200611770C | — | OK |