Organization
GUARDIAN PHARMACY OF EASTERN NC, LLC
Active
Organization
GUARDIAN PHARMACY OF EASTERN NC, LLC
Active
Other names
Southern Pharmacy Services Winston-Salem
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD TERRY (CO-PRESIDENT)
(866) 768-8479
Entity
Organization
Contact information
Practice address
1029 E MOUNTAIN ST, KERNERSVILLE, NC 27284-7902
(866) 768-8479
(866) 928-3983
Mailing address
GUARDIAN PHARMACY OF EASTERN NC, LLC, 1029 E MOUNTAIN ST, KERNERSVILLE, NC 27284-7902
(404) 389-1383
(404) 389-1384
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336L0003X
Long Term Care Pharmacy
Primary
10965
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130222
PK
—
Enumeration date
03/30/2011
Last updated
07/23/2024
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