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General NPI Number Information
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NPI Number | 1861798613
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Entity Type | Organization
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Legal Business Name | GUARDIAN PHARMACY OF NW FLORIDA
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 212 N WILSON ST
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City | CRESTVIEW
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State | FL
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Zip | 32536-3438
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Country | US
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Telephone | 850-306-3003
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Fax | 850-306-3004
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Provider Business Mailing Address
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Address Line | GUARDIAN PHARMACY OF NW FLORIDA DEPT 2401 P.O. BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-0001
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Country | US
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Telephone | 404-389-1316
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT DUNN
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Credential |
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Telephone | 850-306-3003
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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 | PH25396
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License Number State | FL
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