Organization
AGRACE LLC
Active
Other names
Agrace Pharma
Organization subpart
No
Provider details
NPI number
Authorized official
ADISESHU GELLI (PRESIDENT)
(833) 224-7223
Entity
Organization
Contact information
Practice address
721 W TARRANT RD STE 110, GRAND PRAIRIE, TX 75050-3445
(833) 224-7223
(214) 412-2405
Mailing address
721 W TARRANT RD STE 110, GRAND PRAIRIE, TX 75050-3445
(833) 224-7223
(214) 412-2405
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
28456
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
04/17/2012
Last updated
02/05/2021
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