Healthcare Provider Details

I. General information

NPI: 1639034929
Provider Name (Legal Business Name): GRACE MCCRORIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9835 MONROE RD
CHARLOTTE NC
28270-1471
US

IV. Provider business mailing address

9835 MONROE RD
CHARLOTTE NC
28270-1471
US

V. Phone/Fax

Practice location:
  • Phone: 704-322-4065
  • Fax:
Mailing address:
  • Phone: 704-322-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number33203
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: