GUARDIAN PHARMACY OF EASTERN NC, LLC (NPI# 1730478827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730478827 |
| Entity Type | Organization |
| Organization Name | GUARDIAN PHARMACY OF EASTERN NC, LLC |
| Other Organization Name | SOUTHERN PHARMACY SERVICES WINSTON-SALEM |
| Practice Address |
1031 E Mountain St Bldg 319 Kernersville NC 27284-7998 |
| Mailing Address |
Guardian Pharmacy of Eastern Nc Dept 2416 P.o. Box 11407 Birmingham AL 35246-0001 |
| Practice Telephone | 8667688479 |
| Mailing Telephone | 4043891383 |
| Mailing Fax Number | 4043891384 |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2014-10-24 |
| Authorized Official Name | CHAD TERRY (CO-PRESIDENT) |
| Authorized Official Telephone | 8667688479 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
10965 | NC | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2130222 | 01 |
| Other Name | Type Code |
|---|---|
| Southern Pharmacy Services Winston-Salem | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821387911 | Guardian Pharmacy of Eastern Nc, LLC | Pharmacy | 4459 Tarheel Dr, Pink Hill, NC 28572-9649 | 2011-03-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | Guardian Pharmacy of Eastern NC, LLC | 1776 Peachtree Street, N.W., Suite 500, South Tower , Atlanta, GA 30309-2307 |
| Virginia Business Entity | Guardian Pharmacy of Eastern NC, LLC | 171 17TH STREET NW SUITE 1400, ATLANTA, GA 30363 |
| Street Address |
1031 E MOUNTAIN ST BLDG 319 |
| City | KERNERSVILLE |
| State | NC |
| Zip Code | 27284-7998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104029602 | Cecil Manning Davis | Pharmacist | 1031 E Mountain St Bldg 319, Kernersville, NC 27284-7998 | 2007-06-11 |
| 1114531860 | Rachael Kennedy | Pharmacist | 1031 E Mountain St Bldg 319, Kernersville, NC 27284-7998 | 2020-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549047 | Katie Lee Sherman | Student in an Organized Health Care Education/Training Program | 9372 Pumpkin Ridge Rd, Kernersville, NC 27284 | 2020-02-07 |
| 1861049231 | Bethany Medical Center | Internal Medicine | 975 Hwy 66 S, Kernersville, NC 27284 | 2019-08-21 |
| 1114490810 | Lindsey Sarvis | Social Worker | 2301 Lake Shore Reserve Court, Kernersville, NC 27284 | 2019-01-04 |
| 1073091088 | Gastroenterology Associates of The Piedmont, P.a. | Internal Medicine | 445 Pineview Dr Ste 200b, Kernersville, NC 27284 | 2018-08-01 |
| 1942786629 | Brea Anjanee' Washington | Nurse Practitioner | 1635 Nc 66 South, Suite 145, Kernersville, NC 27284 | 2018-07-16 |
| 1992216246 | Charley Elizabeth Cummings | Physician Assistant | 1635 Nc-66, Kernersville, NC 27284 | 2017-10-13 |
| 1902324304 | Susan Marie Garcia | Counselor | 822 Old Winston Road, Suite 5, Kernersville, NC 27284 | 2017-09-06 |
| 1871034603 | Ljp Lab LLC | Clinical Medical Laboratory | 495 Arbor Hill Rd Ste S, Kernersville, NC 27284 | 2017-03-13 |
| 1912446253 | Knew Era Consulting | Counselor | 335 Creekview Drive, Kernersville, NC 27284 | 2017-02-20 |
| 1144686593 | Amber Moore | Counselor | 822 Old Winston Rd, Suite 5, Kernersville, NC 27284 | 2016-01-14 |
| Find all providers in zip 27284 | ||||
| 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 |
|---|---|---|---|---|
| 1902084700 | Ricetta Rx North Carolina, LLC. | Pharmacy | 556 Arbor Hill Rd, Suite J, Kernersville, NC 27284-3375 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982236584 | Premier Pharmacy and Wellness Center LLC | Pharmacy | 3010 Monroe Rd Ste 101, Charlotte, NC 28205-7533 | 2020-02-11 |
| 1114564564 | Gaben | Pharmacy | 6602 Knightdale Blvd Ste 120, Knightdale, NC 27545-6567 | 2019-12-04 |
| 1316588346 | Nuevo Health, Inc | Pharmacy | 937 Old Knight Rd, Knightdale, NC 27545-9065 | 2019-10-01 |
| 1164987996 | Austin Drugs, Inc | Pharmacy | 3513 Suite B Highway 74 E, Monroe, NC 28110 | 2019-02-06 |
| 1326503657 | Village Pharmacy of Hampstead Inc | Pharmacy | 14057 Hwy 17, Suite 100, Hampstead, NC 28443 | 2019-01-31 |
| 1689148496 | Pharmscript of Nc LLC | Pharmacy | 140 Southcenter Ct Ste 600, Morrisville, NC 27560-8538 | 2019-01-15 |
| 1356812432 | Polaris Pharmacy Services of North Carolina, LLC | Pharmacy | 3300 Monroe Rd Unit E&f, Charlotte, NC 28205-7853 | 2018-12-16 |
| 1043799356 | Nelan LLC | Pharmacy | 3541 Randolph Rd Ste 104, Charlotte, NC 28211-1081 | 2018-08-08 |
| 1699280008 | The Script LLC | Pharmacy | 1450 Shaire Center Drive, Hudson, NC 28638 | 2017-12-07 |
| 1528592813 | Triad Choice Pharmacy | Pharmacy | 658 Waughtown St, Winston Salem, NC 27107-2217 | 2017-04-13 |
| Find all providers with the same taxonomy | ||||
| City | KERNERSVILLE |
| Zip Code | 27284 |
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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.