Guardian Pharmacy of Grand Rapids, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

GUARDIAN PHARMACY OF GRAND RAPIDS, LLC

Doing business as

GUARDIAN PHARMACY OF MICHIGAN

Practice address

2930 29TH St SE
Grand Rapids, MI 49512-1723

Phone

(616) 965-7480

Fax

(616) 974-8205

NPI assigned

Sep 12, 2019

Organization subpart

No

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

Authorized official

Name

Nathan Stauffer

Title

Vice President

Phone

(616) 965-7480

Specialties & licenses 1

Addresses

Other names 1

• GUARDIAN PHARMACY OF MICHIGAN Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Guardian Pharmacy of Grand Rapids, LLC

  • Long Term Care Pharmacy
  • Brighton, MI
  • NPI 1558073056

  O20210726003695

  Same enrollment

Tax ID family

Guardian Pharmacy of Eastern Michigan2 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 Grand Rapids, LLC

  • Long Term Care Pharmacy
  • Brighton, MI
  • NPI 1558073056
  NPD tax ID

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1225688229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 11407",
            "address_2": "DEPT # 8130",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468130",
            "telephone_number": "404-389-1383",
            "fax_number": "404-389-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121723",
            "telephone_number": "616-965-7480",
            "fax_number": "616-974-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF GRAND RAPIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-12",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "STAUFFER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "616-965-7480"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "trucareltc.com",
            "affiliation": "N",
            "endpointDescription": "HIE",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Exchange (HIE)",
            "address_1": "2930 29th St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495121723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "GUARDIAN PHARMACY OF MICHIGAN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GUARDIAN PHARMACY OF MICHIGAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ellie Gschwendtner, MD
• Emily Adele Gualtieri Riley, M.D.
• Zhe Guan
• Jesus Guardado, CAREGIVER
• Guardian Angels Private Homecare Corp.
• Alexius Guardiola
• Erica Guastella
• Erica Lee Gudelsky, NP
• Tiffany A Gudger
• Donald Clyde Guernsey, MS LMFT

• Long Term Care Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.