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General NPI Number Information
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NPI Number | 1487128450
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Entity Type | Organization
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Legal Business Name | GRACE HEALTH PHARMACY-MANCHESTER
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 85 HIGHWAY 80
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City | MANCHESTER
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State | KY
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Zip | 40962-8801
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Country | US
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Telephone | 606-596-0410
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Fax | 606-596-0051
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Provider Business Mailing Address
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Address Line | 85 HIGHWAY 80
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City | MANCHESTER
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State | KY
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Zip | 40962-8801
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Country | US
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Telephone | 606-596-0410
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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 | 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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