Grubbs Pharmacy SE Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RX1200011 Issued in DC

Legal business name

GRUBBS PHARMACY SE INC

Practice address

1800 Martin Luther King Jr Ave SE
Washington, DC 20020-6900

Phone

(202) 503-3610

Fax

(202) 503-2639

NPI assigned

Apr 12, 2012

Organization subpart

No

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

Authorized official

Name

Michael Kim, PHARM.D.

Title

Owner/VP

Phone

(202) 543-4400

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Grubb's SE Pharmacy and Mini-mart Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 3

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

• William Fadel, RPH

  • Pharmacist
  • Washington, DC
  • NPI 1710243902
  NPD
• Carla Daniel, PHARMD

  • Pharmacist
  • Charlottesville, VA
  • NPI 1013606318
  NPD
• Sukriti Kaushal, PHARMD

  • Pharmacist
  • Washington, DC
  • NPI 1124665252
  NPD (past)

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1104183342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200206900",
            "telephone_number": "202-503-3610",
            "fax_number": "202-503-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200206900",
            "telephone_number": "202-503-3610",
            "fax_number": "202-503-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUBBS PHARMACY SE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/VP",
        "authorized_official_telephone_number": "202-543-4400",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DC",
            "license": "RX1200011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grubb's SE Pharmacy and Mini-mart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tikia Charonda Grover
• Marvin F. Grower, DDS
• Grubbs Care Pharmacy NW Inc.
• Grubbs Pharmacy of DC Inc
• Grubbs Pharmacy of DC Inc
• Emma Grubbs, RD
• Jessica Mary-Kathryne Grubbs, SPT, ATC
• Carolyn Chattin Gruber
• Aida Gruden
• Maria Grullon-Gonzalez

• Community/Retail Pharmacy in Washington, DC
• Providers in Washington, DC by specialty
• Community/Retail Pharmacy in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.