Provider Demographics
NPI:1285166363
Name:GUARDIAN PHARMACY OF ORLANDO, LLC
Entity type:Organization
Organization Name:GUARDIAN PHARMACY OF ORLANDO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-270-6722
Mailing Address - Street 1:PO BOX 11407
Mailing Address - Street 2:DEPT #5599
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-5599
Mailing Address - Country:US
Mailing Address - Phone:404-810-0089
Mailing Address - Fax:404-810-0094
Practice Address - Street 1:2815 DIRECTORS ROW
Practice Address - Street 2:SUITE 700
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5526
Practice Address - Country:US
Practice Address - Phone:404-270-6722
Practice Address - Fax:407-270-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy