Provider Demographics
NPI:1437900867
Name:GUARDIAN PHARMACY OF UTAH LLC
Entity type:Organization
Organization Name:GUARDIAN PHARMACY OF UTAH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REECE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-497-3575
Mailing Address - Street 1:1790 SABIN DR
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-6747
Mailing Address - Country:US
Mailing Address - Phone:208-497-3575
Mailing Address - Fax:208-552-2103
Practice Address - Street 1:3489 W 2100 S STE 350
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-5897
Practice Address - Country:US
Practice Address - Phone:385-324-2508
Practice Address - Fax:208-552-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy