Provider Demographics
NPI:1013726637
Name:GRACE COMMUNITY PHARMACY, INC.
Entity type:Organization
Organization Name:GRACE COMMUNITY PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MINJUNG
Authorized Official - Middle Name:K
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHD
Authorized Official - Phone:562-860-0586
Mailing Address - Street 1:4881 LA PALMA AVE
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2019
Mailing Address - Country:US
Mailing Address - Phone:562-860-0586
Mailing Address - Fax:562-860-0767
Practice Address - Street 1:4881 LA PALMA AVE
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2019
Practice Address - Country:US
Practice Address - Phone:562-860-0586
Practice Address - Fax:562-860-0767
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRACE COMMUNITY PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy