NPIMap

Organization Active NPI

Grace Health Pharmacy

  • Community/Retail Pharmacy
  • Aurora, CO
National Provider Identifier
1366889115
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1680000031 Issued in CO
Legal business name
GRACE HEALTH PHARMACY
Practice address
3191 S Vaughn Way Unit 102
Unit 102
Aurora, CO 80014-3505
Phone
(720) 748-2449
Fax
(720) 748-5324
NPI assigned
Jun 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Authorized official

Name
Paul KoernerNPI 1760890149
Title
Pharmacy Manager
Phone
(720) 748-2449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1680000031 CO Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

3191 S Vaughn Way Unit 102
Unit 102
Aurora, CO 80014-3505

Mailing address

3191 S Vaughn Way # 102
Aurora, CO 80014-3505
Phone (720) 748-2449

Other identifiers 2

IdentifierTypeStateIssuer
2140370OtherPK
21004820MedicaidCO

Other names 1

  • Grace Health Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grace Health 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.

Locations

3191 S Vaughn Way
#102
Aurora, CO 80014
Phone (720) 748-2449

3191 S Vaughn Way
Unit 102
Aurora, CO 80014
Phone (720) 748-2449

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1366889115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 S VAUGHN WAY # 102",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800143505",
            "telephone_number": "720-748-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 S VAUGHN WAY UNIT 102",
            "address_2": "UNIT 102",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800143505",
            "telephone_number": "720-748-2449",
            "fax_number": "720-748-5324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALTH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "KOERNER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "720-748-2449"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "1680000031",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140370",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21004820",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.