Healthcare Provider Details

I. General information

NPI: 1992394118
Provider Name (Legal Business Name): JOYCE GRUBB RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 NC HIGHWAY 88 W
WARRENSVILLE NC
28693-9209
US

IV. Provider business mailing address

PO BOX 288
WARRENSVILLE NC
28693-0288
US

V. Phone/Fax

Practice location:
  • Phone: 336-384-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12154
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: