# GRACE RX PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grace Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730919754
- **Authorized official:** MADLEN BASILYAN (PRESIDENT/CEO)
- **Authorized official phone:** (818) 875-4158

## Contact information

- **Practice address:** 1724 E WASHINGTON BLVD, PASADENA, CA 91104-2751
- **Practice address phone:** (818) 957-5555
- **Mailing address:** 1724 E WASHINGTON BLVD, PASADENA, CA 91104-2751
- **Mailing address phone:** (818) 957-5555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/05/2024
- **Last updated:** 08/05/2024