| NPI | 1346984838 |
|---|---|
| Doing Business As | GRAND PHARMACY 111 |
| Entity Type | Organization |
| Authorized Contact | BAIN PATRIE Credentialing Manager 203-777-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2024-05-13 |