Provider Demographics
NPI:1922763028
Name:GRACE PHARMACY SOLUTIONS LLC
Entity Type:Organization
Organization Name:GRACE PHARMACY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE ANN
Authorized Official - Middle Name:PINILI
Authorized Official - Last Name:BENET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-597-9099
Mailing Address - Street 1:80 PINNACLES DR STE 900
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2915
Mailing Address - Country:US
Mailing Address - Phone:386-263-7370
Mailing Address - Fax:386-263-7270
Practice Address - Street 1:80 PINNACLES DR STE 900
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2915
Practice Address - Country:US
Practice Address - Phone:386-263-7370
Practice Address - Fax:386-263-7270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy