Organization
DIVINE GRACE PHARMACY LLC
Active
Other names
Divine Grace Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE T GBADAMOSI BSC (OWNER/PHARMACIST)
(430) 630-2600
Entity
Organization
Contact information
Practice address
1970 US HIGHWAY 259 S # 100, DIANA, TX 75640-4037
(430) 625-2600
(430) 625-2600
Mailing address
2058 ROSEBURY LN, FORNEY, TX 75126-0917
(903) 445-7306
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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