Provider Demographics
NPI:1780930529
Name:GRUBBS, JOAN (RPH)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 GOLFVIEW DR
Mailing Address - Street 2:#207
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3830
Mailing Address - Country:US
Mailing Address - Phone:248-643-6544
Mailing Address - Fax:248-643-4343
Practice Address - Street 1:5510 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2620
Practice Address - Country:US
Practice Address - Phone:847-588-7170
Practice Address - Fax:847-588-7060
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302020625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist