NPIMap

Organization Active NPI

Grace Community Pharmacy, Inc.

  • Long Term Care Pharmacy
  • La Palma, CA
National Provider Identifier
1013726637
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GRACE COMMUNITY PHARMACY, INC.
Practice address
4881 La Palma Ave
La Palma, CA 90623-2019
Phone
(562) 860-0586
Fax
(562) 860-0767
NPI assigned
Jan 7, 2025
Organization subpart
Yes
Parent organization
GRACE COMMUNITY PHARMACY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Minjung K Park, RPH, PHDNPI 1780191312
Title
Ceo
Phone
(562) 860-0586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

4881 La Palma Ave
La Palma, CA 90623-2019

Mailing address

4881 La Palma Ave
La Palma, CA 90623-2019
Phone (562) 860-0586

National Provider Directory

National Provider Directory
Tax ID family
Grace Community Pharmacy Inc2 organizations share this tax ID, including this one
Part of
Grace Community Pharmacy Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1013726637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232019",
            "telephone_number": "562-860-0586",
            "fax_number": "562-860-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906232019",
            "telephone_number": "562-860-0586",
            "fax_number": "562-860-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COMMUNITY PHARMACY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRACE COMMUNITY PHARMACY, INC.",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MINJUNG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-860-0586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "RPH, PHD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.