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General NPI Number Information
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NPI Number | 1437900867
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Entity Type | Organization
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Legal Business Name | GUARDIAN PHARMACY OF UTAH LLC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3489 W 2100 S STE 350
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-5897
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Country | US
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Telephone | 385-324-2508
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Fax | 208-552-2103
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Provider Business Mailing Address
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Address Line | 1790 SABIN DR
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City | AMMON
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State | ID
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Zip | 83406-6747
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Country | US
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Telephone | 208-497-3575
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Fax | 208-552-2103
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | REECE CHRISTENSEN
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Credential |
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Telephone | 208-497-3575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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