Organization
GRUBBS PHARMACY SE INC
Active
Other names
Grubb's SE Pharmacy and Mini-mart
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KIM PHARM.D. (OWNER/VP)
(202) 543-4400
Entity
Organization
Contact information
Practice address
1800 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-6900
(202) 503-3610
(202) 503-2639
Mailing address
1800 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-6900
(202) 503-3610
(202) 503-2639
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RX1200011
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135251
PK
—
Enumeration date
04/12/2012
Last updated
12/05/2016
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