Angela Grimball, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS 52554 Issued in FL

Practice address

14965 Old Saint Augustine Rd Unit 108
Jacksonville, FL 32258-9481

Phone

(904) 619-9000

NPI assigned

Oct 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1194128082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14965 OLD SAINT AUGUSTINE RD",
            "address_2": "UNIT 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589480",
            "telephone_number": "850-443-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14965 OLD SAINT AUGUSTINE RD UNIT 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589481",
            "telephone_number": "904-619-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMBALL",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 52554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larissa Lynn Grigsby, LMT
• John P Grim, DDS
• Macy Grim, LPCC
• Frank Grimaldi Jr., PA-C, ATC
• Brian Grimard, MD
• Hallie Elizabeth Grimes
• Joshua Kyle Grimes
• Linda Lee Grimes
• Yolanda Anternett Grimes, LPN
• Richard Scott Grimshaw, O.D.

• Pharmacist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.