Organization
GRACE HEALTH PHARMACY
Active
Other names
Grace Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KOERNER (PHARMACY MANAGER)
(720) 748-2449
Entity
Organization
Contact information
Practice address
3191 S VAUGHN WAY UNIT 102, UNIT 102, AURORA, CO 80014-3505
(720) 748-2449
(720) 748-5324
Mailing address
3191 S VAUGHN WAY # 102, AURORA, CO 80014-3505
(720) 748-2449
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1680000031
CO
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21004820
—
CO
01
—
2140370
PK
—
Enumeration date
06/03/2013
Last updated
06/07/2022
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