Healthcare Provider Details

I. General information

NPI: 1386649028
Provider Name (Legal Business Name): GRUBBS PHARMACY OF DC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2005
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 E CAPITOL ST NE
WASHINGTON DC
20003-3809
US

IV. Provider business mailing address

326 E CAPITOL ST NE
WASHINGTON DC
20003-3809
US

V. Phone/Fax

Practice location:
  • Phone: 202-543-4400
  • Fax: 202-547-1314
Mailing address:
  • Phone: 202-543-4400
  • Fax: 202-547-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRX8800077
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J KIM
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 202-543-4400