Granville Medical Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

GRANVILLE MEDICAL PHARMACY INC.

Practice address

6212 N Broadway St
Chicago, IL 60660-1903

Phone

(773) 274-5888

Fax

(773) 274-5961

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert S. Joseph, RPH.

Title

President/Pharmacist

Phone

(847) 729-9034

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013968023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6212 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601903",
            "telephone_number": "773-274-5888",
            "fax_number": "773-274-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6212 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601903",
            "telephone_number": "773-274-5888",
            "fax_number": "773-274-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANVILLE MEDICAL PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "847-729-9034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAPB",
            "identifier": "1438387",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tysheann Seporia Grant, PHD
• Wanda Felicia Grant, PH.D.
• Jodi Grantham, PT
• Juliette Lane Grantham
• Lani Granum, M.A., L.C.S.W.
• Amaris Granville
• Melissa Leigh Granville, LLMSW
• Melissa Granzow
• Michael Granzow
• Cristina Terhoeve Graphia, M.D.

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.