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NPI Code Detail

MEDICARE: GUARDIAN PHARMACY OF KENTUCKY, LLC

MEDICARE: GUARDIAN PHARMACY OF KENTUCKY, 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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0004XCompounding Pharmacy
43336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1295680635
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN PHARMACY OF KENTUCKY, LLC
Provider Business Mailing Address
First Line : 2025 LEESTOWN RD STE R
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1000
Country : US
Telephone Number : 859-222-0490
Fax Number : 859-222-0491
Provider Business Practice Location Address
First Line : 2025 LEESTOWN RD STE R
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1000
Country : US
Telephone Number : 859-222-0490
Fax Number : 859-222-0491
Authorized Official
Title or Position : PRESIDENT
Name : THOMAS MULLANEY
Credential :
Telephone Number : 859-222-0490
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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