GUARDIAN PHARMACY OF VIRGINIA LLC (NPI# 1447500400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447500400 |
| Entity Type | Organization |
| Organization Name | GUARDIAN PHARMACY OF VIRGINIA LLC |
| Other Organization Name | SOUTHERN PHARMACY SERVICES |
| Practice Address |
860 Stafford Umberger Dr Wytheville VA 24382 |
| Mailing Address |
Guardian Pharmacy of Virginia Dept 2428 P.o. Box 11407 Birmingham AL 35246-2428 |
| Practice Telephone | 2762285940 |
| Practice Fax Number | 8669283983 |
| Mailing Telephone | 4048100089 |
| Mailing Fax Number | 4048100094 |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2018-08-10 |
| Authorized Official Name | CHAD TERRY (PRESIDENT) |
| Authorized Official Telephone | 8667688479 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
MO0559211 | WV | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
11375 | NC | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
3903 | TN | Suppliers |
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
201003165 | VA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810024876 | 05 | |
| VA | 1447500400 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 4844266 | 01 |
| Other Name | Type Code |
|---|---|
| Southern Pharmacy Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Guardian Pharmacy of Virginia LLC | 171 17th Street Nw, Suite 1400, Atlanta, Georgia 30363 |
| Street Address |
860 STAFFORD UMBERGER DR |
| City | WYTHEVILLE |
| State | VA |
| Zip Code | 24382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709118 | Pt Solutions LLC | Physical Therapist | 1050 Holston Road, Wytheville, VA 24382 | 2020-01-10 |
| 1881233377 | Amie S Newberry | Physical Therapist | 1050 Holston Rd, Wytheville, VA 24382 | 2019-12-31 |
| 1174160618 | Erin Leigh Dejesus | Family Medicine | 375 W Ridge Rd, Wytheville, VA 24382 | 2019-12-03 |
| 1629639497 | Family Preservatrion Services, Inc. | Community/Behavioral Health | 425 Grayson Presbyterian Road, Wytheville, VA 24382 | 2019-06-24 |
| 1023527926 | Emily Kingrey | Occupational Therapist | 800 E Main St., Suite 310, Wytheville, VA 24382 | 2017-09-22 |
| 1184149247 | Linda Huber | Driver | 610 E Washington St, Wytheville, VA 24382 | 2017-08-10 |
| 1578987558 | Family Preservation Services, Inc | Community/Behavioral Health | 695 East Marshall Street, Wytheville, VA 24382 | 2014-02-11 |
| 1255774121 | Forest Pharmacy Inc | Pharmacy | 1787 W Lee Highway, Suite B, Wytheville, VA 24382 | 2013-04-10 |
| 1669604385 | Catherine Elizabeth Russell | Physical Therapist | 710 West Ridge Rd, Suites E & F, Wytheville, VA 24382 | 2009-08-13 |
| 1558522938 | Brock Hughes Free Clinic, Inc. | Clinic/Center | 450 West Monroe Street, Wytheville, VA 24382 | 2008-06-19 |
| Find all providers in zip 24382 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770601296 | Horizon Healthcare | Pharmacy | 185 Stafford Umberger Rd, Wytheville, VA 24382-4439 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053957787 | Vithalla, LLC | Pharmacy | 8573 Sudley Rd, Manassas, VA 20110-3808 | 2019-11-18 |
| 1730738170 | Hope Pharmacy, Inc. | Pharmacy | 1330 N 25th St, Richmond, VA 23223-5243 | 2019-09-09 |
| 1790202695 | Friendship Pharmacy, Inc. | Pharmacy | 327 Hershberger Rd., Roanoke, VA 24012 | 2017-08-23 |
| 1346770856 | Claypool Hill Pharmacy | Pharmacy | 12252 Governor G C Peery Hwy, Pounding Mill, VA 24637-4272 | 2017-06-18 |
| 1841738895 | Martinsville Pharmacy Inc | Pharmacy | 1049 Brookdale St Ste A, Martinsville, VA 24112-3972 | 2017-02-09 |
| 1457898892 | Valley Pharmacies, Inc. | Pharmacy | 6701 Peters Creek Rd Ste 109, Roanoke, VA 24019-4060 | 2017-01-24 |
| 1679929145 | Central Virginia Pharmacy Consultants PC | Pharmacy | 20276 Timberlake Rd, Lynchburg, VA 24502-7214 | 2016-05-13 |
| 1134587181 | Pharmacy Corporation of America | Pharmacy | 4423 Pheasant Ridge Rd, Suite 205, Roanoke, VA 24014-5299 | 2016-02-05 |
| 1376825547 | Legacy Consultant Pharmacy | Pharmacy | 7505 Right Flank Rd Ste 710, Mechanicsville, VA 23116-3865 | 2011-09-14 |
| 1568681716 | Pharmacy Alternatives, LLC | Pharmacy | 255 Industrial Dr, Pal Suite, Christiansburg, VA 24073-2538 | 2007-04-25 |
| Find all providers with the same taxonomy | ||||
| City | WYTHEVILLE |
| Zip Code | 24382 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.