Organization
GRANT LINE PHARMACY INC
Active
Other names
GRANT LINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BEATLE TRAN PHARMD (CEO/PHARMACIST)
(209) 832-2999
Entity
Organization
Contact information
Practice address
2160 W GRANT LINE RD, STE 205, TRACY, CA 95377-7330
(209) 832-2999
(209) 221-0909
Mailing address
2160 W GRANT LINE RD, STE 205, TRACY, CA 95377-7330
(209) 832-2999
(209) 221-0909
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY48989
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386816205
—
CA
01
—
2113308
PK
—
Enumeration date
04/01/2008
Last updated
07/19/2018
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