Grand Ave Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55334 Issued in TX

Legal business name

GRAND AVE PHARMACY

Practice address

1615 Grand Avenue Pkwy
Suite 104
Pflugerville, TX 78660-2059

Phone

(512) 377-1999

NPI assigned

Aug 8, 2014

Organization subpart

No

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

Authorized official

Name

Chris Adlakha

Title

Pharmacy Manager

Phone

(512) 377-1999

Specialties & licenses 2

Addresses

Locations

Practitioners 5

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

• Michael J Jaquez

  • Pharmacist
  • Austin, TX
  • NPI 1093816027
  NPD
• Patrick Cason, PHARMD

  • Pharmacist
  • Pflugerville, TX
  • NPI 1417657685
  NPD (past)
• Deborah Malpica, PHARMD

  • Pharmacist
  • Pflugerville, TX
  • NPI 1144872722
  NPD (past)
• Armin Roshan

  • Pharmacist
  • Pflugerville, TX
  • NPI 1013542133
  NPD (past)
• Ravi Kiran Davuluri, PHARM.D.

  • Pharmacist
  • Ann Arbor, MI
  • NPI 1306249156
  NPD (past)

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407456000000",
    "number": "1972912418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 GRAND AVENUE PKWY",
            "address_2": "SUITE 104",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602059",
            "telephone_number": "512-377-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 GRAND AVENUE PKWY",
            "address_2": "SUITE 104",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602059",
            "telephone_number": "512-377-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND AVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A",
        "authorized_official_last_name": "ADLAKHA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "512-377-1999"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "55334",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TX",
            "license": "55334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Marie Govednik, M.D.
• GPK Pediatrics, PLLC
• Samantha A Graef, PA-C
• Aurora Elizabeth Graham, NP
• Mary Graham, LVN
• Lekeba Tier Granger, DMD
• Nhi Graves, APRN
• Great Hills Eye Care, PC
• Daisy Green
• Sierra Green

• All providers in Pflugerville, TX
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; 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.