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Contact Information

GUARDIAN PHARMACY OF VIRGINIA LLC
860 STAFFORD UMBERGER DR
WYTHEVILLE, VA24382
 Phone: 276-228-5940
 Fax: 866-928-3983
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GUARDIAN PHARMACY OF VIRGINIA LLC

NPI Number 1447500400
LBN Legal business name GUARDIAN PHARMACY OF VIRGINIA LLC
Authorized official CHAD TERRY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/17/2012
Last updated 08/10/2018 - About 8 years ago
Identifiers
NC License # 11375
TN License # 3903
VA License # 201003165
WV License # MO0559211
VA Medicaid 1447500400
WV Medicaid 3810024876
Other 4844266 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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