Agrace LLC

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

Legal business name

AGRACE LLC

Doing business as

Agrace Pharma

Practice address

721 W Tarrant Rd Ste 110
Grand Prairie, TX 75050-3445

Phone

(833) 224-7223

Fax

(469) 986-1180

NPI assigned

Jan 18, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Adiseshu GelliNPI 1568092542

Title

President

Phone

(833) 224-7223

Specialties & licenses 2

Addresses

Other names 1

• Agrace Pharma Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adiseshu Gelli

  • Pharmacist
  • Grand Prairie, TX
  • NPI 1568092542
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1386274363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W TARRANT RD STE 110",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750503445",
            "telephone_number": "833-224-7223",
            "fax_number": "469-986-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W TARRANT RD STE 110",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750503445",
            "telephone_number": "833-224-7223",
            "fax_number": "469-986-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "GELLI",
        "authorized_official_first_name": "ADISESHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "833-224-7223",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agrace Pharma",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agrace Pharma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialty Pharmacy in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Specialty Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.