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General NPI Number Information
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NPI Number | 1366086126
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Entity Type | Organization
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Legal Business Name | GRACE PHARMACY SOLUTIONS LLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 80 PINNACLES DR STE 900
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City | PALM COAST
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State | FL
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Zip | 32164-2915
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Country | US
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Telephone | 386-263-7370
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Fax | 386-263-7270
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Provider Business Mailing Address
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Address Line | 54 RYARBOR DR
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City | PALM COAST
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State | FL
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Zip | 32164-3417
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Country | US
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Telephone | 386-263-7370
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Fax |
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Authorized Official
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Title or Position | PHARMACIST, OWNER
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Name | MISS GRACE ANN PINILI BENET
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Credential |
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Telephone | 386-237-1821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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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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