Healthcare Provider Details

I. General information

NPI: 1801180625
Provider Name (Legal Business Name): GUARDIAN PHARMACY OF ATLANTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 FRANKLIN GTWY SE STE 200
MARIETTA GA
30067-8009
US

IV. Provider business mailing address

GUARDIAN PHARMACY OF ATLANTA DEPT 2447 P.O. BOX 11407
BIRMINGHAM AL
35246-0001
US

V. Phone/Fax

Practice location:
  • Phone: 770-635-3301
  • Fax: 770-635-3302
Mailing address:
  • Phone: 404-389-1316
  • Fax: 404-389-1317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHRE009760
License Number StateGA

VIII. Authorized Official

Name: MATT HOPP
Title or Position: PRESIDENT
Credential:
Phone: 770-635-3303