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G AND J GROSS INC. NPI 1083744916


NPI Information

NPI: 1083744916
Provider Name: G AND J GROSS, INC.

Doing Business As: MICKEY FINE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 05D2115819

Address:
433 N ROXBURY DR
BEVERLY HILLS, CA
ZIP 90210
Phone: (310) 271-6123
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G AND J GROSS, INC. is a community/retail pharmacy pharmacy in Beverly Hills, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. G AND J GROSS, INC. NPI is 1083744916. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mickey Fine Pharmacy.

The provider's business location address is:

433 N ROXBURY DR
BEVERLY HILLS, CA
ZIP 90210-001
Phone: (310) 271-6123
Fax: (310) 273-5339

The provider's authorized official is Jeffrey Gross .
The authorized official title is President and has the following contact phone number (310) 271-6123.

The CLIA number assigned to this NPI record is 05D2115819 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 1/7/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163WD0400XRegistered NurseDiabetes EducatorNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyPHY51055CALIFORNIAYes
43336C0004XPharmacyCompounding PharmacyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11083744916MEDICAIDCALIFORNIA
22136312OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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