MEDICARE: GUARDIAN PHARMACY OF POMPANO BEACH

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	3336L0003X	Long Term Care Pharmacy	PH22043	FL

General Provider Information

NPI Number	:	1609802164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUARDIAN PHARMACY OF POMPANO BEACH

Provider Business Mailing Address
First Line	:	1776 PEACHTREE ST NW
Second Line	:	SUITE 310, SOUTH TOWER
City	:	ATLANTA
State	:	GA
Zip	:	30309-2307
Country	:	US
Telephone Number	:	404-810-0089
Fax Number	:	404-810-0094

Provider Business Practice Location Address
First Line	:	1903 W COPANS RD
Second Line	:	SUITE B
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-1517
Country	:	US
Telephone Number	:	954-582-5209
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. DAVID K MORRIS
Credential	:
Telephone Number	:	404-810-0089

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	08/01/2007

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