GUARDIAN PHARMACY OF MAINE LLC NPI 1871672469

NPI Information

NPI: 1871672469
Provider Name: GUARDIAN PHARMACY OF MAINE, LLC

Doing Business As: WALTZ LONG TERM CARE PHARMACY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 20D2190246

Address:
3 BUSINESS PKWY
SUITE 2
BRUNSWICK, ME
ZIP 04011
Phone: (207) 373-9077
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GUARDIAN PHARMACY OF MAINE, LLC is a long term care pharmacy pharmacy in Brunswick, ME. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. GUARDIAN PHARMACY OF MAINE, LLC NPI is 1871672469. The provider is registered as an organization entity type.
The provider Is Doing Business As Waltz Long Term Care Pharmacy.

The provider's business location address is:

3 BUSINESS PKWY
SUITE 2
BRUNSWICK, ME
ZIP 04011-390
Phone: (207) 373-9077
Fax: (207) 373-9088

The provider's authorized official is Courtney Oland .
The authorized official title is President and has the following contact phone number (207) 373-9077.

The CLIA number assigned to this NPI record is 20D2190246 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2006 and was last updated on 2/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	3336L0003X	Pharmacy	Long Term Care Pharmacy	CSP50001564	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E100200569	OTHER	MAINE	MEDICARE- MASS IMMUNIZATION
2	1871672469	MEDICAID	MAINE
3	CSP50001564	OTHER	MAINE	PHARMACY LICENSE
4	2007537	OTHER	MAINE	NABP#
5	3099413	MEDICAID	NEW HAMPSHIRE
6	5991980001	MEDICARE NSC	MAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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