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Organization
GUARDIAN PHARMACY OF GRAND RAPIDS, LLC
Active
Organization
GUARDIAN PHARMACY OF GRAND RAPIDS, LLC
Active
Other names
Guardian Pharmacy of Eastern Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN STAUFFER (PRESIDENT/OWNER)
(616) 446-4018
Entity
Organization
Contact information
Practice address
10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
(810) 626-5880
(810) 626-5881
Mailing address
10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
(810) 626-5880
(810) 626-5881
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301013032
MI BOP LICENSE
MI
Enumeration date
12/16/2022
Last updated
12/16/2022
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