Guardian Pharmacy of Virginia LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

201003165 Issued in VA

Legal business name

GUARDIAN PHARMACY OF VIRGINIA LLC

Doing business as

Southern Pharmacy Services

Practice address

860 Stafford Umberger Dr
Wytheville, VA 24382

Phone

(276) 228-5940

Fax

(866) 928-3983

NPI assigned

Sep 17, 2012

Last updated

Aug 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chad Terry

Title

President

Phone

(866) 768-8479

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Southern Pharmacy Services Doing business as

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renae Cregger, PHARMD

  • Pharmacist
  • Wytheville, VA
  • NPI 1215692199
  NPD (past)
• Carrie Turner, RN

  • Registered Nurse
  • Wytheville, VA
  • NPI 1437814365
  NPD (past)

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533859200000",
    "number": "1447500400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUARDIAN PHARMACY OF VIRGINIA DEPT 2428",
            "address_2": "P.O. BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462428",
            "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": "860 STAFFORD UMBERGER DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "24382",
            "telephone_number": "276-228-5940",
            "fax_number": "866-928-3983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2018-08-10",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "866-768-8479"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "VA",
            "license": "201003165",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WV",
            "license": "MO0559211",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "11375",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "TN",
            "license": "3903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447500400",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810024876",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4844266",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan R Griffin, MD
• Celeste Ann Griffith, RN
• Cara Grubb, DPT
• Guardian Ambulance Service
• Guardian Emergency Medical Services, Inc
• Tammy Lynn Guinn, FNP-C
• H2 Rehabilitation Services of Virginia LLC (H2 Health)
• H2 Rehabilitation Services of Virginia LLC (H2 Health)
• H2 Rehabilitation Services of Virginia, LLC (H2 Health)
• H2 Rehabilitation Services of Virginia, LLC (H2 Health)

• Long Term Care Pharmacy in Wytheville, VA
• Providers in Wytheville, VA by specialty
• Long Term Care Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.