Healthcare Provider Details

I. General information

NPI: 1003581323
Provider Name (Legal Business Name): GRACE YUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 LAWRENCEVILLE SUWANEE RD
SUWANEE GA
30024-2657
US

IV. Provider business mailing address

2121 LAWRENCEVILLE SUWANEE RD
SUWANEE GA
30024-2657
US

V. Phone/Fax

Practice location:
  • Phone: 771-962-1352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH033094
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH033094
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: