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Organization
GUARDIAN PHARMACY OF MAINE, LLC
Active
Organization
GUARDIAN PHARMACY OF MAINE, LLC
Active
Other names
WALTZ LONG TERM CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY OLAND (PRESIDENT)
(207) 373-9077
Entity
Organization
Contact information
Practice address
3 BUSINESS PKWY, SUITE 2, BRUNSWICK, ME 04011-7390
(207) 373-9077
(207) 373-9088
Mailing address
GUARDIAN PHARMACY OF MAINE DEPT 2374, P.O. BOX 11407, BIRMINGHAM, AL 35246-2374
(404) 810-0089
(404) 810-0094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
CSP50001564
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871672469
—
ME
01
—
2007537
NABP#
ME
05
—
3099413
—
NH
01
—
CSP50001564
PHARMACY LICENSE
ME
01
—
E100200569
MEDICARE- MASS IMMUNIZATION
ME
Enumeration date
11/03/2006
Last updated
02/13/2017
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