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1841912508 NPI number — GRACE

NPI Number: 1841912508
Health Care Provider/Practitioner: GRACE

Information about “1841912508” NPI (GRACE) exists in 1841912508 in HTML format HTML  |  1841912508 in plain Text format TXT  |  1841912508 in PDF (Portable Document Format) PDF  |  1841912508 in an XML format XML  formats.

NPI Number : 1841912508 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841912508",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "GRACE COMMUNITY HEALTH CENTER INC",
    "ParentOrgTIN": null,
    "OrgName": "GRACE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1019 CUMBERLAND FALLS HWY STE B201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORBIN",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40701",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "606-526-9005",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "14662 N US HIGHWAY 25 E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CORBIN",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40701",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-526-9005",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/19/2022",
    "LastUpdateDate": "07/21/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WHITTAKER",
    "AuthorizedOfficialFirstName": "DAVID",
    "AuthorizedOfficialMiddleName": "CASEY",
    "AuthorizedOfficialTitle": "DIRECTOR OF PHARMACY",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHARMD",
    "AuthorizedOfficialTelephoneNumber": "606-526-9005",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "333600000X",
          "TaxonomyName": "Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0003X",
          "TaxonomyName": "Community/Retail Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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