Guardian Pharmacy of Madison, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

9504-42 Issued in WI

Legal business name

GUARDIAN PHARMACY OF MADISON, LLC

Doing business as

Mallatt's Home Care Pharmacy

Practice address

3250 Kingsley Way
Madison, WI 53713-1383

Phone

(608) 310-9922

Fax

(608) 442-8490

NPI assigned

Apr 17, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

GUARDIAN PHARMACY, LLCAs reported in NPPES

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

Authorized official

Name

Jeff Tuch, CPA

Title

VP-Purchasing & Payor Relations

Phone

(404) 532-5011

Specialties & licenses 1

Addresses

Other names 1

• Mallatt's Home Care Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Guardian Pharmacy of Madison, LLC

  dba Guardian Pharmacy of Wisconsin

  • Long Term Care Pharmacy
  • West Allis, WI
  • NPI 1578038022

  5092064113

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Guardian Pharmacy of Madison LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Guardian Pharmacy of Madison, LLC

  dba Guardian Pharmacy of Wisconsin

  • Long Term Care Pharmacy
  • West Allis, WI
  • NPI 1578038022
  NPD tax ID

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Saint John's Communities, Inc.

  • Skilled Nursing Facility
  • Milwaukee, WI
  • NPI 1295866325

  Adp of the SNF

  CMS ownership

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1043707987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 KINGSLEY WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131383",
            "telephone_number": "608-310-9922",
            "fax_number": "608-442-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 KINGSLEY WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131383",
            "telephone_number": "608-310-9922",
            "fax_number": "608-442-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF MADISON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUARDIAN PHARMACY, LLC",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "TUCH",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP-PURCHASING & PAYOR RELATIONS",
        "authorized_official_telephone_number": "404-532-5011",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "9504-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mallatt's Home Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Ann Gryttenholm, PHARMD.
• Patricia Grzebielski, M.D.
• Danielle Grzelak, DPT
• Jeffrey Grzybowski, M.D.
• Bartosz J Grzywacz, M.D.
• Megan Guckeen
• Nicholas Guden
• Thorbjorn Gudjonsson, MD
• Holly M Guenther, APNP
• Jill M Guenther, PA

• Long Term Care Pharmacy in Madison, WI
• Providers in Madison, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.