MEDICARE: GUARDIAN PHARMACY OF IOWA 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336L0003X	Long Term Care Pharmacy	1623	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2175025	OTHER		PK

General Provider Information

NPI Number	:	1447762885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN PHARMACY OF IOWA LLC

Provider Business Mailing Address
First Line	:	PO BOX 11407
Second Line	:	DEPT #5861
City	:	BIRMINGHAM
State	:	AL
Zip	:	35246-5861
Country	:	US
Telephone Number	:	515-963-1640
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 ROCKWELL DR NE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-7216
Country	:	US
Telephone Number	:	319-214-5265
Fax Number	:	515-963-7752

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROCKFORD ANDERSON
Credential	:
Telephone Number	:	515-963-1640

Provider Enumeration Date	:	10/25/2017
Last Update Date	:	01/02/2026

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