# GUARDIAN PHARMACY OF GRAND RAPIDS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Guardian Pharmacy of Eastern Michigan
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558073056
- **Authorized official:** NATHAN STAUFFER (PRESIDENT/OWNER)
- **Authorized official phone:** (616) 446-4018

## Contact information

- **Practice address:** 10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
- **Practice address phone:** (810) 626-5880
- **Practice address fax:** (810) 626-5881
- **Mailing address:** 10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
- **Mailing address phone:** (810) 626-5880
- **Mailing address fax:** (810) 626-5881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2022
- **Last updated:** 12/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5301013032 | MI BOP LICENSE | MI |