Organization
GUARDIAN PHARMACY OF TULSA, LLC
Active
Other names
Boomer Solutions of Tulsa
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY BURGESS (PRESIDENT)
(866) 237-8217
Entity
Organization
Contact information
Practice address
5415 S 125TH EAST AVE, SUITE 201-203, TULSA, OK 74146-6232
(866) 237-8217
(855) 711-3900
Mailing address
PO BOX 11407, DEPT # 2610, BIRMINGHAM, AL 35246-2610
(404) 810-0089
(404) 810-0094
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
2-7811
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200611770C
—
OK
Enumeration date
02/26/2016
Last updated
02/24/2017
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