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NPI Code Detail

MEDICARE: GUARDIAN PHARMACY OF CINCINNATI, LLC

MEDICARE: GUARDIAN PHARMACY OF CINCINNATI, 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
13336C0003XCommunity/Retail Pharmacy
23336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1801406780
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUARDIAN PHARMACY OF CINCINNATI, LLC
Provider Business Mailing Address
First Line : 1825 COMMERCE CENTER BLVD STE 121
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-6336
Country : US
Telephone Number : 513-242-5700
Fax Number : 513-482-5461
Provider Business Practice Location Address
First Line : 1825 COMMERCE CENTER BLVD STE 121
Second Line :
City : FAIRBORN
State : OH
Zip : 45324-6336
Country : US
Telephone Number : 513-242-5700
Fax Number : 513-482-5461
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : THOMAS MULLANEY
Credential :
Telephone Number : 513-587-6201
Provider Enumeration Date : 08/05/2020
Last Update Date : 06/17/2024

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