Organization
VMLC GRACE HULEN, LLC
Active
Parent organization
VMLC GRACE HULEN
Other names
Gateway Pharmacy LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VMLC GRACE HULEN
Authorized official
MAGGIE MANKARIOUS (PHARMACIST)
(682) 400-3366
Entity
Organization
Contact information
Practice address
5505 S HULEN ST, FORT WORTH, TX 76132-2200
(682) 400-3366
Mailing address
5505 S HULEN ST, FORT WORTH, TX 76132-2200
(682) 400-3366
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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