Universal Grace Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010751 Issued in MI

Legal business name

UNIVERSAL GRACE PHARMACY LLC

Doing business as

Universal Grace Pharmacy

Practice address

31500 Dequindre Rd Ste 300
Warren, MI 48092-1057

Phone

(586) 999-5951

Fax

(586) 999-5956

NPI assigned

Oct 16, 2015

Organization subpart

No

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

Authorized official

Name

Nofal Cholag

Title

Owner, Pic, Ao

Phone

(586) 999-5951

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Universal Grace Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1417328436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31500 DEQUINDRE RD STE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921057",
            "telephone_number": "586-999-5951",
            "fax_number": "586-999-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 DEQUINDRE RD STE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921057",
            "telephone_number": "586-999-5951",
            "fax_number": "586-999-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSAL GRACE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "CHOLAG",
        "authorized_official_first_name": "NOFAL",
        "authorized_official_title_or_position": "OWNER, PIC, AO",
        "authorized_official_telephone_number": "586-999-5951"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010751",
            "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": "2154721",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Universal Grace Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Warren, MI
• Providers in Warren, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.