Grace RX Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

GRACE RX PHARMACY INC

Practice address

1724 E Washington Blvd
Pasadena, CA 91104-2751

Phone

(818) 957-5555

Fax

(818) 957-5551

NPI assigned

Aug 15, 2012

Organization subpart

No

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

Authorized official

Name

Madlen Basilyan, PHARM DNPI 1003448796

Title

President/Ceo

Phone

(818) 957-5555

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GRACE PHARMACY Doing business as

Tax ID family

Grace Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grace RX Pharmacy Inc

  • Long Term Care Pharmacy
  • Pasadena, CA
  • NPI 1730919754
  NPD tax ID

Locations

Practitioners 1

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

• Madlen Basilyan, RPH

  • Pharmacist
  • Tujunga, CA
  • NPI 1003448796
  NPD Authorized official

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1295083764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 E WASHINGTON BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042751",
            "telephone_number": "818-957-5555",
            "fax_number": "818-957-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 E WASHINGTON BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042751",
            "telephone_number": "818-957-5555",
            "fax_number": "818-957-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A",
        "authorized_official_last_name": "BASILYAN",
        "authorized_official_first_name": "MADLEN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-957-5555",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY59258",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Stuart Gottlieb, MD
• Sara Shirrell Gottlieb, LM, CPM, IBCLC
• Lashay Areria Marie Goulding
• Arielle Tenaya Marie Gout, OT
• Sameer Goyal
• Grace RX Pharmacy Inc
• Adrianne Marie Grace, NP
• Edwin Borcelis Graham, RN
• Jacob Joseph Gordon Graham
• Jessica Antoinette Graham

• All providers in Pasadena, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.