Grand Medical Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2008019033 Issued in MO

Legal business name

GRAND MEDICAL GROUP LLC

Doing business as

Medicine Shoppe

Practice address

3137 S Grand Blvd
Saint Louis, MO 63118-1020

Phone

(314) 865-1528

Fax

(314) 865-5219

NPI assigned

Jun 17, 2008

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

Practitioners 2

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

• Lauren Choi

  • Pharmacist
  • Saint Louis, MO
  • NPI 1962024414
  NPD (past)
• Juliana Doria, PHARMD

  • Pharmacist
  • Saint Louis, MO
  • NPI 1598340333
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1841450442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3137 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181020",
            "telephone_number": "314-865-1528",
            "fax_number": "314-865-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3137 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181020",
            "telephone_number": "314-865-1528",
            "fax_number": "314-865-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2008019033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2638027",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Elizabeth Granberg, MD, MPH
• Steven J Granberg, MD
• Grand Manor Health Care Center, L.L.C. (Grand Manor Health Care Center)
• Grand Manor Nursing & Rehabilitation Center, L.L.C.
• Grand Manor SNF Opco LLC (Grand Manor Health Care Center)
• Mark Gilbert Grand, MD
• Allyson M Granden, NP-C
• Laura Granderson
• Grandmom Honey LLC
• Thomas M Graney, PA

• Community/Retail Pharmacy in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.