MEDICARE: GUARDIAN PHARMACY OF UTAH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1437900867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN PHARMACY OF UTAH LLC

Provider Business Mailing Address
First Line	:	1790 SABIN DR
Second Line	:
City	:	AMMON
State	:	ID
Zip	:	83406-6747
Country	:	US
Telephone Number	:	208-497-3575
Fax Number	:	208-552-2103

Provider Business Practice Location Address
First Line	:	3489 W 2100 S STE 350
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84119-5897
Country	:	US
Telephone Number	:	385-324-2508
Fax Number	:	208-552-2103

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	REECE CHRISTENSEN
Credential	:
Telephone Number	:	208-497-3575

Provider Enumeration Date	:	04/01/2024
Last Update Date	:	05/08/2025

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