Healthcare Provider Details

I. General information

NPI: 1710553649
Provider Name (Legal Business Name): HANNAH ROSE GRICE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW
WASHINGTON DC
20006-1602
US

IV. Provider business mailing address

6060 MONTEVISTA LANE APT 1114
FORT WORTH TX
76132
US

V. Phone/Fax

Practice location:
  • Phone: 202-765-1429
  • Fax:
Mailing address:
  • Phone: 806-300-9971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number36467
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: