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General NPI Number Information
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NPI Number | 1356795678
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Entity Type | Organization
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Legal Business Name | VMC GRACE LLC
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 921 FM 1187 E STE A
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City | CROWLEY
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State | TX
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Zip | 76036-4364
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Country | US
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Telephone | 817-297-2000
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Fax | 817-297-2010
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Provider Business Mailing Address
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Address Line | 921 FM 1187 E STE A
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City | CROWLEY
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State | TX
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Zip | 76036-4364
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Country | US
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Telephone | 817-297-2000
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Fax | 817-297-2010
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Authorized Official
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Title or Position | OWNER, PIC, AO
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Name | MAGGIE MANKARIOUS
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Credential | RPH
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Telephone | 682-234-2309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 30786
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License Number State | TX
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