# GUARDIAN HEALTHCARE PHARMACY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GUARDIAN HEALTHCARE PHARMACY, LLC, GUARDIAN HEALTHCARE PHARMACY, GUARDIAN LONG TERM CARE PHARMACY, INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316952948
- **Authorized official:** MATTHEW J VARACALLO PHARM D (PHARMACY MANAGER)
- **Authorized official phone:** (888) 503-7474

## Contact information

- **Practice address:** 123 BRUBAKER RD, BROCKWAY, PA 15824-2505
- **Practice address phone:** (888) 503-7474
- **Practice address fax:** (877) 371-5677
- **Mailing address:** 123 BRUBAKER RD, BROCKWAY, PA 15824-2505
- **Mailing address phone:** (888) 503-7474
- **Mailing address fax:** (877) 371-5677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PP481523 | PA | Yes |

## Other

- **Enumeration date:** 07/30/2006
- **Last updated:** 11/14/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02163160000014708 | — | OH |
| 05 | — | 1015064750001 | — | PA |
| 01 | — | 2087733 | PK | — |