Organization
GUARDIAN PHARMACY OF MISSOURI LLC
Active
Other names
Guardian Pharmacy of Missouri
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COUNTS (PRESIDENT)
(417) 864-5873
Entity
Organization
Contact information
Practice address
2107 E ROCKHURST ST STE C, SPRINGFIELD, MO 65802-6502
(417) 864-5873
(417) 864-5874
Mailing address
2107 E ROCKHURST ST STE C, SPRINGFIELD, MO 65802-6502
(404) 810-0094
(404) 810-0089
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
2016023396
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326490376
—
MO
01
—
2166287
PK
—
Enumeration date
07/01/2016
Last updated
10/30/2018
Update your record
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