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General NPI Number Information
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NPI Number | 1548915937
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Entity Type | Organization
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Legal Business Name | TRUE GRACE PHARMACEUTICAL
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 50 ECORSE RD
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City | YPSILANTI
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State | MI
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Zip | 48198-5711
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Country | US
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Telephone | 734-340-6645
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Fax |
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Provider Business Mailing Address
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Address Line | 50 ECORSE RD
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City | YPSILANTI
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State | MI
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Zip | 48198-5711
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Country | US
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Telephone | 734-340-6645
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KEITH ATOWO
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Credential | PHARMD
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Telephone | 734-383-8219
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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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