Provider Demographics
NPI:1609802164
Name:GUARDIAN PHARMACY OF POMPANO BEACH
Entity Type:Organization
Organization Name:GUARDIAN PHARMACY OF POMPANO BEACH
Other - Org Name:PRIORITY PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-810-0089
Mailing Address - Street 1:1776 PEACHTREE ST NW
Mailing Address - Street 2:SUITE 310, SOUTH TOWER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2307
Mailing Address - Country:US
Mailing Address - Phone:404-810-0089
Mailing Address - Fax:404-810-0094
Practice Address - Street 1:1903 W COPANS RD
Practice Address - Street 2:SUITE B
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-1517
Practice Address - Country:US
Practice Address - Phone:954-582-5209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH220433336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy