Healthcare Provider Details

I. General information

NPI: 1952858730
Provider Name (Legal Business Name): GRM PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2016
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 ROCK RD
GLEN ROCK NJ
07452-1707
US

IV. Provider business mailing address

3070 MCCANN FARM DR STE 101
GARNET VALLEY PA
19060-2131
US

V. Phone/Fax

Practice location:
  • Phone: 201-444-3200
  • Fax: 201-444-5792
Mailing address:
  • Phone: 201-444-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00344000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number28RS00344000
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number28RS00344000
License Number StateNJ

VIII. Authorized Official

Name: NICHOLAS KARALIS
Title or Position: CEO & PRESIDENT
Credential:
Phone: 610-545-6040