# GUARDIAN PHARMACY OF MADISON, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GUARDIAN PHARMACY, LLC
- **Other names:** Mallatt's Home Care Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962999805
- **Legal business name:** GUARDIAN PHARMACY, LLC
- **Authorized official:** JEFF TUCH CPA (VP-PURCHASING & PAYOR RELATIONS)
- **Authorized official phone:** (404) 532-5011

## Contact information

- **Practice address:** N85 W15882 APPLETON AVE, MENOMONEE FALLS, WI 53051-3082
- **Practice address phone:** (262) 437-0031
- **Practice address fax:** (262) 255-2058
- **Mailing address:** N85 W15882 APPLETON AVE, MENOMONEE FALLS, WI 53051-3082
- **Mailing address phone:** (262) 437-0031
- **Mailing address fax:** (262) 255-2058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 9503-42 | WI | Yes |

## Other

- **Enumeration date:** 04/17/2018
- **Last updated:** 04/17/2018