DIVINE GRACE PHARMACY LLC (NPI# 1164086245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164086245 |
| Entity Type | Organization |
| Organization Name | DIVINE GRACE PHARMACY LLC |
| Practice Address |
1970 Us Highway 259 S # 100 Diana TX 75640-4037 |
| Mailing Address |
2058 Rosebury Ln Forney TX 75126-0917 |
| Practice Telephone | 4306252600 |
| Practice Fax Number | 4306252600 |
| Mailing Telephone | 9034457306 |
| Enumeration Date | 2019-04-24 |
| Last Update Date | 2019-04-24 |
| Authorized Official Name | GRACE T GBADAMOSI (OWNER/PHARMACIST) |
| Authorized Official Telephone | 4306302600 |
| Authorized Official Credential | BSC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Pharmacy Service Providers |
| Other Name | Type Code |
|---|---|
| Divine Grace Pharmacy | Doing Business As Name - Organization |
| Street Address |
1970 US HIGHWAY 259 S # 100 |
| City | DIANA |
| State | TX |
| Zip Code | 75640-4037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033603097 | Teresa M Phillips | Physical Therapy Assistant | 14145 State Highway 154 E, Diana, TX 75640 | 2018-06-21 |
| 1326402280 | Crystal Whitfield | Specialist/Technologist | 119 Grace Ln, Diana, TX 75640 | 2016-04-07 |
| 1629688023 | March Ellen Gray | Registered Nurse | 2162 Us Highway 259 S, Diana, TX 75640 | 2020-07-31 |
| 1942343322 | New Diana Isd | Local Education Agency (LEA) | 1373 Us Hwy 259 S, Diana, TX 75640-2651 | 2007-02-15 |
| 1215407416 | Candy Renita Scott | Counselor | 2815 Yellow Rose Rd, Diana, TX 75640-2698 | 2018-11-29 |
| 1962772509 | Philippa A Donaghy | Physical Therapist | 2777 Zinnia Rd, Diana, TX 75640-3019 | 2012-01-12 |
| 1376175653 | Stormi Breann Waddell | Registered Nurse | 12304 Blackman Rd, Diana, TX 75640-3421 | 2020-02-05 |
| 1841691649 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 1787 Us Highway 259 S, Diana, TX 75640-3503 | 2014-09-11 |
| 1528600574 | Shearren Johnson | Family Medicine | 2162 Us Highway 259 S, Diana, TX 75640-3510 | 2019-10-10 |
| 1841823176 | Alexis Christine Ormes | Naturopath | 10323 State Highway 154 E, Diana, TX 75640-3698 | 2020-02-14 |
| Find all providers in zip 75640 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801497813 | Cindy Layton Potter | Pharmacist | 400 Myrtle St, Nacogdoches, TX 75965-2652 | 2020-11-05 |
| 1306446398 | Claud Cameron | Pharmacist | 23552 Nameless Rd, Leander, TX 78641-9022 | 2020-10-28 |
| 1306445234 | Chloe Lee | Pharmacist | 4620 Sh 121, Lewisville, TX 75056-4530 | 2020-10-21 |
| 1205435195 | Scott Sadlowski | Pharmacist | 12605 I-45 N, Willis, TX 77318 | 2020-10-21 |
| 1891394102 | Shaunda Lynn Jackson | Pharmacist | 19250 W Lake Houston Pkwy, Humble, TX 77346-2279 | 2020-10-19 |
| 1841898251 | Pablo Reyna Castro | Pharmacist | 3100 S Gordon St, Alvin, TX 77511-4790 | 2020-10-16 |
| 1659979078 | Tina Teresa Cherian | Pharmacist | 341 S Loop 336 W, Conroe, TX 77304-3309 | 2020-10-16 |
| 1316545742 | Travis Jones | Pharmacist | 6767 Spencer Highway, Pasadena, TX 77505 | 2020-10-16 |
| 1396350666 | Patient Care Services Pharmacy Consulting, LLC | Pharmacist | 2000 N Central Expy Ste 214, Plano, TX 75074-5487 | 2020-09-13 |
| 1942813209 | Mountaineer Consultants LLC | Pharmacist | 933 Pellegrino Ave, El Paso, TX 79932-2063 | 2020-08-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.