Guardian Pharmacy of Iowa, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1621 Issued in IA

Legal business name

GUARDIAN PHARMACY OF IOWA, LLC

Practice address

1325 SW Oralabor Rd
Ste 200
Ankeny, IA 50023-8046

Phone

(515) 289-4008

Fax

(515) 289-2383

NPI assigned

Oct 25, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rockford Anderson

Title

President

Phone

(515) 963-1640

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Ankeny Pharmacy Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1013429455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "address_2": "DEPT #5862",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352465862",
            "telephone_number": "404-810-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SW ORALABOR RD",
            "address_2": "STE 200",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500238046",
            "telephone_number": "515-289-4008",
            "fax_number": "515-289-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF IOWA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROCKFORD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-963-1640"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1621",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0410866",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175018",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ankeny Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Guardian Pharmacy of Iowa LLC
• Ashley Gullett, DO
• George M Gura, DO
• Blake Lowell Haan, D.C.
• Mary Haas, DO
• Addison Haines

• Community/Retail Pharmacy in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Community/Retail Pharmacy in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.