Active NPI
Brian J Graci, RPH
- Pharmacist
- Brookhaven, PA
National Provider Identifier
1366710873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP042991L
- Practice address
- 4098 Edgmont Ave
Brookhaven, PA 19015-2211 - Phone
- (610) 876-8815
- Fax
- (610) 876-8868
- NPI assigned
- Dec 12, 2011
- Last updated
- Dec 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP042991L | PA | Primary |
Addresses
Primary practice location
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Mailing address
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Phone (610) 876-8815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP042991L | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Take Care Health Pennsylvania, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Nurse Practitioner
- Rochester, PA
- NPI 1922050384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323648000000",
"number": "1366710873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4098 EDGMONT AVE",
"city": "BROOKHAVEN",
"state": "PA",
"postal_code": "190152211",
"telephone_number": "610-876-8815",
"fax_number": "610-876-8868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4098 EDGMONT AVE",
"city": "BROOKHAVEN",
"state": "PA",
"postal_code": "190152211",
"telephone_number": "610-876-8815",
"fax_number": "610-876-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACI",
"first_name": "BRIAN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-12",
"last_updated": "2011-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP042991L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.