# GUARDIAN PHARMACY OF IDAHO FALLS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heartland Pharmacy - Idaho Falls
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639920051
- **Authorized official:** REECE CHRISTENSEN (PRESIDENT/OWNER)
- **Authorized official phone:** (208) 497-3575

## Contact information

- **Practice address:** 3250 E 17TH ST, AMMON, ID 83406-6758
- **Practice address phone:** (208) 552-7677
- **Practice address fax:** (208) 552-2098
- **Mailing address:** 1790 SABIN DR, AMMON, ID 83406-6747
- **Mailing address phone:** (208) 497-3575
- **Mailing address fax:** (208) 552-2103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/01/2024
- **Last updated:** 08/02/2024