Healthcare Provider Details

I. General information

NPI: 1649215179
Provider Name (Legal Business Name): GRACE HEALTHCARE SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 02/14/2022
Certification Date: 02/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 W COVINA BLVD STE 100
SAN DIMAS CA
91773-3200
US

IV. Provider business mailing address

1330 W COVINA BLVD STE 100
SAN DIMAS CA
91773
US

V. Phone/Fax

Practice location:
  • Phone: 909-599-8369
  • Fax: 909-599-8360
Mailing address:
  • Phone: 909-599-8369
  • Fax: 909-599-8360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. SHIH-PING CHEN
Title or Position: PRESIDENT/CEO
Credential: PHARM D
Phone: 909-599-8369