Organization
GUARDIAN PHARMACY OF GRAND RAPIDS, LLC
Active
Other names
Guardian Pharmacy of Eastern Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN STAUFFER (PRESIDENT/OWNER)
(616) 446-4018
Entity
Organization
Contact information
Practice address
10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
(810) 626-5880
(810) 626-5881
Mailing address
10381 CITATION DR STE 500, BRIGHTON, MI 48116-6527
(810) 626-5880
(810) 626-5881
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301013032
MI BOP LICENSE
MI
Enumeration date
12/16/2022
Last updated
12/16/2022
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