Guardian Pharmacy of Maine, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

CSP50001564 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

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Courtney Oland

Title

President

Phone

(207) 373-9077

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• WALTZ LONG TERM CARE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in ME2 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.

Medicare medical equipment & supply locations

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

  • Nursing Facility/Intermediate Care Facility
  • Brunswick, ME
  • NPI 1366807695
  NPD tax ID

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": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1871672469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GUARDIAN PHARMACY OF MAINE DEPT 2374",
            "address_2": "P.O. BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352462374",
            "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": "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": "2006-11-03",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "OLAND",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-373-9077"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "ME",
            "license": "CSP50001564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099413",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "CSP50001564",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- MASS IMMUNIZATION",
            "identifier": "E100200569",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871672469",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP#",
            "identifier": "2007537",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALTZ LONG TERM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Melissa Arnel Hagar, FNP

• Long Term Care Pharmacy in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Long Term Care Pharmacy in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.