Provider Demographics
NPI:1891511416
Name:GUARDIAN PHARMACY OF NEW JERSEY LLC
Entity type:Organization
Organization Name:GUARDIAN PHARMACY OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WITZAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-352-5530
Mailing Address - Street 1:1248 SUSSEX TPKE # B9
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2908
Mailing Address - Country:US
Mailing Address - Phone:862-352-5530
Mailing Address - Fax:862-352-3661
Practice Address - Street 1:1248 SUSSEX TPKE # B9
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2908
Practice Address - Country:US
Practice Address - Phone:862-352-5530
Practice Address - Fax:862-352-3661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No333600000XSuppliersPharmacy