Provider Demographics
NPI:1366086126
Name:GRACE PHARMACY SOLUTIONS LLC
Entity type:Organization
Organization Name:GRACE PHARMACY SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST, OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GRACE ANN
Authorized Official - Middle Name:PINILI
Authorized Official - Last Name:BENET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-237-1821
Mailing Address - Street 1:54 RYARBOR DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-3417
Mailing Address - Country:US
Mailing Address - Phone:386-263-7370
Mailing Address - Fax:
Practice Address - Street 1:80 PINNACLES DR STE 900
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2915
Practice Address - Country:US
Practice Address - Phone:386-263-7370
Practice Address - Fax:386-263-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Multi-Specialty
No1835P0200XPharmacy Service ProvidersPharmacistPediatricsGroup - Multi-Specialty
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatricGroup - Multi-Specialty
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Multi-Specialty