Healthcare Provider Details

I. General information

NPI: 1811781776
Provider Name (Legal Business Name): HSUAN-HUI (GRACE) LIU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE LIU PHARMD

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11050 PARKVIEW CIRCLE DR
FORT WAYNE IN
46845-1739
US

IV. Provider business mailing address

11050 PARKVIEW CIRCLE DR STE 3B
FORT WAYNE IN
46845-1739
US

V. Phone/Fax

Practice location:
  • Phone: 260-266-6629
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number32868
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26030723A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: