Gracelight Community Health
LBN: Gracelight Community Health
Gracelight Community Health is an health care organization with primary practice located at 4816 E 3Rd St , Los Angeles CA 90022-1602. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty.
Gracelight Community Health can be contacted via phone (323) 780-4510, or through Snitman, Marina via phone (323) 635-1153.
Contact Information
Primary practice address
4816 E 3Rd St
Los Angeles CA 90022-1602
Phone: (323) 780-4510
Fax: (323) 780-6132
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Pharmacy | 333600000X | ||
Suppliers / Clinic Pharmacy | 3336C0002X |
Profile Details
NPI number | 1992106082 |
---|---|
LBN Legal business name | Gracelight Community Health |
DBA Doing business as | |
Authorized official | Snitman, Marina PHARMD |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Sep 9th, 2014 |
Last updated | May 20th, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992106082 | NPPES |
California | MEDICAID | CMM70660F | |
California | Other | W6997D | |
California | Other | 55-1019 | |
California | Other | PHY 52564 |
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