Provider Demographics
NPI:1871067785
Name:GRACE FAMILY PHARMACY INC.
Entity type:Organization
Organization Name:GRACE FAMILY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-309-1641
Mailing Address - Street 1:5 BAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-4925
Mailing Address - Country:US
Mailing Address - Phone:845-463-2322
Mailing Address - Fax:845-463-2322
Practice Address - Street 1:313 S WILLIAM ST STE 3
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5300
Practice Address - Country:US
Practice Address - Phone:845-569-4100
Practice Address - Fax:845-562-4867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy