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General NPI Number Information
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NPI Number | 1063172534
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Entity Type | Organization
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Legal Business Name | GRACE COMMUNITY HEALTH CENTER INC
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Dates
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Enumeration Date | 12/27/2021
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 934 S LAUREL RD STE 5
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City | LONDON
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State | KY
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Zip | 40744
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Country | US
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Telephone | 606-526-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 CUMBERLAND FALLS HWY STE B201
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City | CORBIN
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State | KY
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Zip | 40701
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Country | US
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Telephone | 606-526-9005
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DR. DAVID CASEY WHITTAKER
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Credential | PHARMD
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Telephone | 606-526-9005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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