Healthcare Provider Details

I. General information

NPI: 1437900867
Provider Name (Legal Business Name): GUARDIAN PHARMACY OF UTAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3489 W 2100 S STE 350
WEST VALLEY CITY UT
84119-5897
US

IV. Provider business mailing address

1790 SABIN DR
AMMON ID
83406-6747
US

V. Phone/Fax

Practice location:
  • Phone: 385-324-2508
  • Fax: 208-552-2103
Mailing address:
  • Phone: 208-497-3575
  • Fax: 208-552-2103

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 Number
License Number State

VIII. Authorized Official

Name: REECE CHRISTENSEN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 208-497-3575