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Organization

GUARDIAN PHARMACY OF SOUTHEAST FLORIDA LLC

Active
Other names
Guardian Pharmacy of Southeast Florida
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN TRASTER (PRESIDENT)
(954) 601-2121
Entity
Organization

Contact information

Practice address
6100 BROKEN SOUND PKWY NW STE 1, BOCA RATON, FL 33487-2790
(954) 601-2121
(954) 601-2400
Mailing address
GUARDIAN PHARMACY OF SOUTHEAST FLORIDA DEPT 2355, P.O. BOX 11407, BIRMINGHAM, AL 35246-0001
(404) 810-0089
(404) 810-0094

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary
PH22966
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
032158300
FL
01
2004166
PK
Enumeration date
12/14/2006
Last updated
06/11/2020
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