Organization Active NPI

Grace Healthcare Solutions Inc

Doing business as San Dimas Pharmacy

  • Community/Retail Pharmacy
  • San Dimas, CA
National Provider Identifier
1649215179
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GRACE HEALTHCARE SOLUTIONS INC
Doing business as
San Dimas Pharmacy
Practice address
1330 W Covina Blvd Ste 100
San Dimas, CA 91773-3200
Phone
(909) 599-8369
Fax
(909) 599-8360
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Authorized official

Name
Ms. Shih-Ping Chen, PHARM DNPI 1013597228
Title
President/Ceo
Phone
(909) 599-8369

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
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1330 W Covina Blvd Ste 100
San Dimas, CA 91773-3200

Mailing address

1330 W Covina Blvd
Ste 100
San Dimas, CA 91773
Phone (909) 599-8369

Other identifiers 2

IdentifierTypeStateIssuer
1649215179MedicaidCA
PHY57952OtherCABOARD OF PHARMACY

Other names 1

  • San Dimas Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210208001491 CA DME Supplier - Pharmacy 9032523824 Practice locations: San Dimas, CA
O20210604001544 CA Part B Supplier - Pharmacy 9032523824 Practice locations: San Dimas, CA
O20240516003971 CA Part B Supplier - Independent Clinical Laboratory 9032523824 Practice locations: San Dimas, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2300198San Dimas Pharmacy1330 W Covina Blvd #100, San Dimas, CA 91773Certificate of waiverMar 4, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
San Dimas Pharmacy1330 W Covina Blvd, San Dimas, CA 91773-3200(909) 599-8369 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Dec 21, 2020

National Provider Directory

National Provider Directory

Locations

1330 W Covina Blvd
Ste 100
San Dimas, CA 91773
Phone (909) 599-8369

Practitioners & affiliated clinicians

Practitioners 1

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1649215179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "STE 100",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "91773",
            "telephone_number": "909-599-8369",
            "fax_number": "909-599-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD STE 100",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-599-8369",
            "fax_number": "909-599-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALTHCARE SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "SHIH-PING",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "909-599-8369",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649215179",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY57952",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Dimas Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.