Provider Demographics
NPI:1427214253
Name:GRANT PHARMACIST GROUP INC
Entity Type:Organization
Organization Name:GRANT PHARMACIST GROUP INC
Other - Org Name:TOTAL CARE PHARMACY #4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRONK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-428-0900
Mailing Address - Street 1:209 S MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:FLEMINGSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41041-1203
Mailing Address - Country:US
Mailing Address - Phone:606-845-2101
Mailing Address - Fax:606-849-2633
Practice Address - Street 1:700 VIOLET RD
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-1101
Practice Address - Country:US
Practice Address - Phone:859-428-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-31
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK019680OtherMASS IMMUNIZER
KY1827077OtherNCPDP
KY7100056090Medicaid
KY4277860001Medicare NSC
KY6332750001Medicare NSC