Organization
GUARDIAN PHARMACY OF SOUTHWEST FLORIDA LLC
Active
Other names
Patient Care Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KLEIN (PRESIDENT)
(941) 255-1987
Entity
Organization
Contact information
Practice address
4873 PLANTATION BLVD., NORTH PORT, FL 34289-9503
(941) 255-1987
(941) 629-5507
Mailing address
PO BOX 11407, DEPT #2464, BIRMINGHAM, AL 35246-2464
(404) 554-1647
(404) 554-1648
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH28854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014310700
—
FL
01
—
2150227
PK
—
Enumeration date
01/30/2015
Last updated
08/27/2021
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