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BOOMER SOLUTIONS OF TULSA
NPI 1194185504
Pharmacy - Long Term Care Pharmacy in Tulsa, OK

Active since February 26, 2016CLIA 37D2234416 · Waiver
5415 S 125TH EAST AVE, SUITE 201-203, TULSA, OK 74146(866) 237-8217(855) 711-3900 Get Directions Write a Review

NPPES record last updated: February 24, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 24, 2017, Jan 3, 2017, Nov 23, 2016 and 1 more (4 updates tracked since 2016).

About Boomer Solutions Of Tulsa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOOMER SOLUTIONS OF TULSA (NPI 1194185504) is a healthcare organization registered as a long term care pharmacy in Tulsa, Oklahoma and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through August 30, 2027 and lists Ricky Burgess, President, as its authorized official.

NPPES Registry Identity

NPI1194185504
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameGUARDIAN PHARMACY OF TULSA, LLC
Location Address5415 S 125TH EAST AVE, SUITE 201-203Tulsa, OK 74146-6232
Mailing AddressPo Box 11407, Dept # 2610Birmingham, AL 35246-2610 · (404) 810-0089 · Fax (404) 810-0094
Phone(866) 237-8217
Fax(855) 711-3900
Organization SubpartNo
Authorized OfficialRicky BurgessPresident · (866) 237-8217
Enumeration DateFebruary 26, 2016
Last NPPES UpdateFebruary 24, 20174 updates tracked since enumeration
✔ NPI 1194185504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
License✔ Licensed in OK · 2-7811
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
5415 S 125TH EAST AVE, Tulsa, OK 74146
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Other Names 1

Doing Business AsBoomer Solutions Of Tulsa

Other Identifiers 2

Medicaid200611770COK
Medicare NSC7465070002OK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2234416

Boomer Solutions Of Tulsa Guardian Pharmacy Of Tulsa · Tulsa, OK
Active · expires Aug 30, 2027
CLIA Number37D2234416
Laboratory TypePharmacy
Certificate Effective DateAugust 31, 2025
Certificate Expiration DateAugust 30, 2027
Laboratory DirectorChris Kaiser
Laboratory Phone(866) 237-8217
Laboratory LocationBoomer Solutions Of Tulsa Guardian Pharmacy Of Tulsa5415 S 125th East Ave, Ste 205, Tulsa, OK 74146
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
1,323 services1,293 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
1,068 services1,068 patients
Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free 90674
The quadrivalent influenza vaccine is a flu shot that protects against four different flu viruses. Derived from cell cultures, it is free of preservatives and antibiotics. It's a safe and effective way to reduce your risk of getting the flu.
27 services27 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
16 services16 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
16 services16 patients
Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage 90694
The quadrivalent inactivated influenza vaccine is a shot given to protect against four strains of the flu virus. This 0.5 ml dosage helps your body develop immunity to the virus. It's an important step in preventing flu-related complications.
14 services14 patients

Medical Equipment Supplier Medicare DMEPOS 4

Medicare supplier enrollment and the product categories Guardian Pharmacy Of Tulsa, LLC carries, from the Medicare DMEPOS supplier directory.

Guardian Pharmacy Of Tulsa, LLC

DMEPOS supplier · Tulsa, OK
✔

Accepts Medicare assignment

Guardian Pharmacy Of Tulsa, LLC agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20467715
Medicare Participant SinceJanuary 1, 2017
Supplier Location5415 S 125th East Ave Ste 201-203Tulsa, OK 74146
Phone(866) 237-8217
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Guardian Pharmacy Of Tulsa, LLC's NPI number?

The NPI number for Guardian Pharmacy Of Tulsa, LLC is 1194185504. It was assigned to this organization in the NPPES registry on February 26, 2016. The provider is doing business as Boomer Solutions Of Tulsa.

Where is Guardian Pharmacy Of Tulsa, LLC located?

Guardian Pharmacy Of Tulsa, LLC is located at 5415 S 125th East Ave Suite 201-203, Tulsa, OK 74146. The listed phone number is (866) 237-8217.

What is Guardian Pharmacy Of Tulsa, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Guardian Pharmacy Of Tulsa, LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Guardian Pharmacy Of Tulsa, LLC accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Guardian Pharmacy Of Tulsa, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2234416) is associated with this NPI, valid through August 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Guardian Pharmacy Of Tulsa, LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Guardian Pharmacy Of Tulsa, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Guardian Pharmacy Of Tulsa, LLC was last updated on February 24, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.