Grand Blanc RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010813 Issued in MI

Legal business name

GRAND BLANC RX LLC

Practice address

8483 Holly Rd Ste 202
Grand Blanc, MI 48439-1840

Phone

(810) 344-6422

Fax

(810) 344-6421

NPI assigned

Nov 2, 2017

Organization subpart

No

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

Authorized official

Name

Candi Tolf

Title

Contract Coordinator

Phone

(248) 862-6148

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Abbey Pharmacy - grand blanc Doing business as

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1124530829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD # 168",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404",
            "telephone_number": "248-862-6148",
            "fax_number": "248-862-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8483 HOLLY RD STE 202",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391840",
            "telephone_number": "810-344-6422",
            "fax_number": "810-344-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND BLANC RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDI",
        "authorized_official_title_or_position": "CONTRACT COORDINATOR",
        "authorized_official_telephone_number": "248-862-6148"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124530829",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2173228",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abbey Pharmacy - grand blanc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grand Blanc Pharmacy LLC
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• Grand Blanc Psychology PLLC
• Grand Blanc Psychology PLLC
• Grand Blanc Rehab Center, LLC
• Grand Blanc Spine Center
• Grand Blanc Therapy
• Grand Blanc Vision Clinic P.C.
• Daniel Alfonso Grasso, DNP, APRN, PMHNP-BC
• Hannah Gray

• Community/Retail Pharmacy in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.