Organization
GRACE CLINIC OF LUBBOCK
Active
Other names
GRACE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 740-3305
(806) 712-1803
Mailing address
PO BOX 676132, DALLAS, TX 75267-6132
(806) 740-3305
(806) 712-1803
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099658
PK
—
Enumeration date
10/23/2006
Last updated
05/09/2025
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