Guardian Pharmacy of Maine LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

PR5462 Issued in ME

Legal business name

GUARDIAN PHARMACY OF MAINE LLC

Doing business as

Waltz Long Term Care Pharmacy

Practice address

3 Business Pkwy
Suite 2
Brunswick, ME 04011-7390

Phone

(207) 373-9077

Fax

(207) 373-9088

NPI assigned

Dec 31, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Courtney Doherty Oland, R.PH.

Title

Director of Pharmacy

Phone

(207) 373-9077

Specialties & licenses 1

Addresses

Other names 1

• Waltz Long Term Care Pharmacy Doing business as

Tax ID family

Guardian Pharmacy of Maine 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 Maine, LLC

  • Long Term Care Pharmacy
  • Brunswick, ME
  • NPI 1871672469
  NPD tax ID

Locations

Practitioners 1

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

• Sarah Elizabeth Mayrose, PHARMD

  • Pharmacist
  • Brunswick, ME
  • NPI 1669202792
  NPD (past)

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451520000000",
    "number": "1366807695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BUSINESS PKWY STE 2",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040117390",
            "telephone_number": "207-373-9077",
            "fax_number": "207-373-9088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BUSINESS PKWY",
            "address_2": "SUITE 2",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040117390",
            "telephone_number": "207-373-9077",
            "fax_number": "207-373-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF MAINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2015-12-31",
        "status": "A",
        "authorized_official_last_name": "OLAND",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "DOHERTY",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "207-373-9077",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ME",
            "license": "PR5462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waltz Long Term Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suzanne Grondin, D.C.
• Amber Gross, LCPC
• Carl W Grove, RPH
• Angela L Grunkemeyer, MSPT
• Guardian Loving Care LLC
• Guardian Pharmacy of Maine, LLC
• Julie Guerrette, PMHNP
• Darrin Paul Guitreau, PA-C
• John J Gullo, MD
• Nancy Patricia Gwadry, APRN-CNP

• Nursing Facility/Intermediate Care Facility in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Nursing Facility/Intermediate Care Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.