Guardian Pharmacy of Madison, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

9503-42 Issued in WI

Legal business name

GUARDIAN PHARMACY OF MADISON, LLC

Doing business as

Mallatt's Home Care Pharmacy

Practice address

N85 W15882 Appleton Ave
Menomonee Falls, WI 53051-3082

Phone

(262) 437-0031

Fax

(262) 255-2058

NPI assigned

Apr 17, 2018

Organization subpart

Yes

Parent organization

GUARDIAN PHARMACY, LLCAs reported in NPPES

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

Authorized official

Name

Jeff Tuch, CPA

Title

VP-Purchasing & Payor Relations

Phone

(404) 532-5011

Specialties & licenses 1

Addresses

Other names 1

• Mallatt's Home Care Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1962999805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N85 W15882 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513082",
            "telephone_number": "262-437-0031",
            "fax_number": "262-255-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N85 W15882 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513082",
            "telephone_number": "262-437-0031",
            "fax_number": "262-255-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN PHARMACY OF MADISON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUARDIAN PHARMACY, LLC",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "TUCH",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP-PURCHASING & PAYOR RELATIONS",
        "authorized_official_telephone_number": "404-532-5011",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "9503-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mallatt's Home Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Mari G Griswold, LCSW
• Mitchell Groth, PHARMD
• Richard J. Grunke, M.D.
• Lori C Gryszkiewicz, OT
• Kathy L Grzendzielewski, RD, CDE
• Guillermo D Varona MD
• Abigail Gumm
• Stephanie Jean Gunderson, MD
• Caitlyn M Gunzel, SLP
• Nilesh I Gupta, M.D.

• Long Term Care Pharmacy in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Long Term Care Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.