Healthcare Provider Details

I. General information

NPI: 1215478342
Provider Name (Legal Business Name): GRACE UNRUH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 MASSACHUSETTS ST
LAWRENCE KS
66044-4256
US

IV. Provider business mailing address

1740 MASSACHUSETTS ST
LAWRENCE KS
66044-4256
US

V. Phone/Fax

Practice location:
  • Phone: 785-842-2434
  • Fax: 785-832-6832
Mailing address:
  • Phone: 785-842-2434
  • Fax: 785-832-6832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number1-16963
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: