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Organization

GUARDIAN PHARMACY SVC LLC

Active
Other names
GUARDIAN PHARMACY SERVICES LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY EDWARDS (PRESIDENT)
(952) 351-4100
Entity
Organization

Contact information

Practice address
9703 VALLEY VIEW RD, EDEN PRAIRIE, MN 55344-3508
(952) 351-4100
(952) 351-4102
Mailing address
9703 VALLEY VIEW RD, EDEN PRAIRIE, MN 55344-3508
(952) 351-4100
(952) 351-4102

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
2624015
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2425898
NCPDP PROVIDER IDENTIFICATION NUMBER
05
941422300
MN
Enumeration date
06/13/2006
Last updated
06/16/2010
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