Divine Grace Pharmacy LLC
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Diana, TX. Organization (NPI-2).
NPI number1164086245
StatusActive
Last updated in NPPESApr 24, 2019
Details
- NPI
- 1164086245
- Entity type
- Organization (NPI-2)
- Legal business name
- Divine Grace Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Apr 24, 2019
- Last updated
- Apr 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | – | – | Yes |
Other names
- Divine Grace Pharmacy (Doing Business As)
Practice location
1970 Us Highway 259 S # 100Diana, TX 75640-4037
Phone 430-625-2600 · Fax 430-625-2600
Mailing address
2058 Rosebury LnForney, TX 75126-0917
Phone 903-445-7306
Authorized official
Grace T Gbadamosi
Owner/Pharmacist
4306302600
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