Brian J Graci, RPH
Individual provider Active NPI Pharmacist · Brookhaven, PA
NPI 1366710873 · NPPES record last updated Dec 12, 2011
Key facts
- NPI
- 1366710873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP042991L (PA)
- Practice address
- 4098 Edgmont Ave
Brookhaven, PA 19015-2211 - Phone
- (610) 876-8815
- Fax
- (610) 876-8868
- NPI assigned
- Dec 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP042991L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Take Care Health Pennsylvania, PC | Past |
Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP042991L | PA | Yes |
Addresses
Primary practice location
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Mailing address
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Phone (610) 876-8815
Other providers in Brookhaven, PA
- Freedom Pharmacy LLC
- Juthamat Fuangthaisong
- Joseph Fuselli
- George L Rodriguez MD PC
- Cherren Glover
- Leesa Gradwell
- Felisa Victoria Guzman
- Paul Frank Haluska
- Michelle Fishbeyn Hammond
- Samuel Hart Jr.
All providers in Brookhaven, PA · Pharmacist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.