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GRUBB'S SE PHARMACY AND MINI-MART
NPI 1104183342
Pharmacy - Community/Retail Pharmacy in Washington, DC

Active since April 12, 2012CLIA 09D0924568 · Waiver
1800 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020(202) 503-3610(202) 503-2639 Get Directions Write a Review

NPPES record last updated: December 5, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Grubb's Se Pharmacy And Mini-mart NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRUBB'S SE PHARMACY AND MINI-MART (NPI 1104183342) is a healthcare organization registered as a community/retail pharmacy in Washington, District Of Columbia and active in the NPI registry since April 2012. The organization holds a CLIA Waiver certificate valid through February 2, 2027 and lists Michael Kim, Owner/vp, as its authorized official.

NPPES Registry Identity

NPI1104183342
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameGRUBBS PHARMACY SE INC
Location Address1800 MARTIN LUTHER KING JR AVE SEWashington, DC 20020-6900
Mailing Address1800 Martin Luther King Jr Ave SeWashington, DC 20020-6900 · (202) 503-3610 · Fax (202) 503-2639
Phone(202) 503-3610
Fax(202) 503-2639
Organization SubpartNo
Authorized OfficialMichael KimOwner/vp · (202) 543-4400
Enumeration DateApril 12, 2012
Last NPPES UpdateDecember 5, 2016
✔ NPI 1104183342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in DC · RX1200011
Definition

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.

Also ListedPharmacyTaxonomy 333600000X
1800 MARTIN LUTHER KING JR AVE SE, Washington, DC 20020
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Other Names 1

Doing Business AsGrubb's Se Pharmacy And Mini-mart

Other Identifiers 1

Other2135251Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 09D0924568

Grubb's Pharmacy Of Dc, Inc · Washington, DC
Active · expires Feb 2, 2027
CLIA Number09D0924568
Laboratory TypePharmacy
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorMichael J. Kim
Laboratory Phone(202) 543-4400
Laboratory LocationGrubb's Pharmacy Of Dc, Inc326 East Capitol Street NE, Washington, DC 20003
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUKRITI KAUSHAL PHARMD
Pharmacist
1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC 20020
District of Columbia (202) 503-3610
WILLIAM FADEL RPH
Pharmacist
1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC 20020
District of Columbia (202) 503-3610
ROLLIN EMERY YIMGA WANDJI
Social Worker
1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC 20020
District of Columbia (202) 442-7200
DENIS CHAP NKEMAYIM MD
Case Manager/Care Coordinator
1800 MARTIN LUTHER KING JR AVE SE
WASHINGTON, DC 20020
District of Columbia (771) 241-3644

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grubbs Pharmacy SE Inc's NPI number?

The NPI number for Grubbs Pharmacy SE Inc is 1104183342. It was assigned to this organization in the NPPES registry on April 12, 2012. The provider is doing business as Grubb's SE Pharmacy And Mini-Mart.

Where is Grubbs Pharmacy SE Inc located?

Grubbs Pharmacy SE Inc is located at 1800 Martin Luther King Jr Ave SE, Washington, DC 20020. The listed phone number is (202) 503-3610.

What is Grubbs Pharmacy SE Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Grubbs Pharmacy SE Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 09D0924568) is associated with this NPI, valid through February 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grubbs Pharmacy SE Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 46 other insurers list Grubbs Pharmacy SE Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grubbs Pharmacy SE Inc was last updated on December 5, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.