Gracious Health Mart LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

GRACIOUS HEALTH MART LLC

Practice address

4237 Salisbury Rd BLDG 3
Jacksonville, FL 32216-8029

Phone

(904) 683-4298

NPI assigned

May 7, 2019

Organization subpart

No

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

Authorized official

Name

Krystal Mims

Title

Owner

Phone

(334) 819-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mass Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771459200000",
    "number": "1245895929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 EASTERN BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361161700",
            "telephone_number": "334-819-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 SALISBURY RD BLDG 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168029",
            "telephone_number": "904-683-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIOUS HEALTH MART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-819-4500"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113393600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mass Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mass Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Elizabeth Grace, BSRT
• Grace'S Senior Care Services
• Gracefully Anchored Psychiatry
• Gracefully Present Home Care LLC
• Julio Gracia, RMHI
• Gracious Manner Inc
• Kalisha Monique Graddick, BA
• Niesha Allegra Graddy
• Hollee Grady
• George Herbert Graf, DDS

• Long Term Care Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.