Graca Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

09191 Issued in NC

Legal business name

GRACA INC

Practice address

143 Rosedale Dr
Elizabeth City, NC 27909-9810

Phone

(252) 331-2965

Fax

(252) 335-0329

NPI assigned

Oct 26, 2006

Organization subpart

No

Name

Dana Goldston, RPH

Title

President

Phone

(940) 754-5857

• COMMUNITY CARE PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2009.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1710062005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1778",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295661778",
            "telephone_number": "252-331-2965",
            "fax_number": "252-335-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 ROSEDALE DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279099810",
            "telephone_number": "252-331-2965",
            "fax_number": "252-335-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "GOLDSTON",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-754-5857",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NC",
            "license": "09191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3404732",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7704429",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kara Golden
• Cole Nicolas Gomez
• Jessica H Gorr, D.O.
• Sowmya Gouru, DDS
• Scott Edward Grabill, D.O.
• Marianne Gradeless, G.O.N.P.
• Robert Grant, M.D.
• Tim Gravgaard
• Wyconda Denise Gray, LCSW
• Taylor Balir Green, PHARMD

• All providers in Elizabeth City, NC
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.