Organization
GUARDIAN LONG TERM CARE PHARMACY INC
Active
Organization
GUARDIAN LONG TERM CARE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN RENDOS (DIRECTOR OF OPERATIONS)
(814) 503-7400
Entity
Organization
Contact information
Practice address
147 OLD NEWPORT ST, STE 1, NANTICOKE, PA 18634-1327
(570) 812-0300
(570) 812-0030
Mailing address
123 BRUBAKER RD, BROCKWAY, PA 15824-2505
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP481661
PA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1015064750002
—
PA
01
—
3988079
OTHER ID NUMBER
—
Enumeration date
03/15/2007
Last updated
12/21/2007
Update your record
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