# GRAND PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689019887
- **Authorized official:** ALIKSANDR BEKETAU (PRESIDENT)
- **Authorized official phone:** (312) 733-8044

## Contact information

- **Practice address:** 2158 W GRAND AVE, 101, CHICAGO, IL 60612-1571
- **Practice address phone:** (312) 733-8044
- **Practice address fax:** (312) 733-8062
- **Mailing address:** 2158 W GRAND AVE, 101, CHICAGO, IL 60612-1571
- **Mailing address phone:** (312) 733-8044
- **Mailing address fax:** (312) 733-8062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/02/2013
- **Last updated:** 04/23/2014