Agrace LLC

Primary specialty

PharmacyTaxonomy code 333600000X

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

(214) 412-2405

NPI assigned

Apr 17, 2012

Last updated

Feb 5, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adiseshu GelliNPI 1568092542

Title

President

Phone

(833) 224-7223

Specialties & licenses 4

Addresses

Other names 1

• Agrace Pharma Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• 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": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1639436561",
    "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": "214-412-2405"
        },
        {
            "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": "214-412-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGRACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28456",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agrace Pharma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.