Organization Active NPI

Guardian Pharmacy of Indianapolis LTC, LLC

Doing business as Guardian Pharmacy of Indiana

  • Long Term Care Pharmacy
  • Indianapolis, IN
National Provider Identifier
1154676476
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
60006311A Issued in IN
Legal business name
GUARDIAN PHARMACY OF INDIANAPOLIS LTC, LLC
Doing business as
Guardian Pharmacy of Indiana
Practice address
6530 Corporate Dr
Indianapolis, IN 46278-2915
Phone
(317) 452-4669
Fax
(866) 320-4744
NPI assigned
Jul 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Authorized official

Name
Steve Piepenbrink
Title
President
Phone
(866) 320-4669

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 60006311A IN Primary

Addresses

Primary practice location

6530 Corporate Dr
Indianapolis, IN 46278-2915

Mailing address

PO Box 11407
Dept # 2421
Birmingham, AL 35246-2421
Phone (404) 810-0089

Other identifiers 2

IdentifierTypeStateIssuer
2136626OtherPK
201081960AMedicaidIN

Other names 1

  • Guardian Pharmacy of Indiana Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171129002704 IN Part B Supplier - Mass Immunization (Roster Biller Only) 4880951888 Practice locations: Indianapolis, IN
O20180212002889 IN DME Supplier - Pharmacy 4880951888 Practice locations: Indianapolis, IN

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Guardian Pharmacy of Indiana6530 Corporate Dr, Indianapolis, IN 46278-2915(866) 320-4669 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 15, 2016

National Provider Directory

National Provider Directory

Locations

6530 Corporate Dr
Indianapolis, IN 46278
Phone (317) 452-4669

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1154676476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "address_2": "DEPT # 2421",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462421",
            "telephone_number": "404-810-0089",
            "fax_number": "404-810-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 CORPORATE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462782915",
            "telephone_number": "317-452-4669",
            "fax_number": "866-320-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF INDIANAPOLIS LTC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "PIEPENBRINK",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-320-4669"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IN",
            "license": "60006311A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136626",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201081960A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guardian Pharmacy of Indiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.