Provider Demographics
NPI:1972617736
Name:GROVEWAY PHARMACY, INC.
Entity Type:Organization
Organization Name:GROVEWAY PHARMACY, INC.
Other - Org Name:GROVEWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:RHIANNA
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-377-1791
Mailing Address - Street 1:PO BOX 273312
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277
Mailing Address - Country:US
Mailing Address - Phone:346-377-1791
Mailing Address - Fax:
Practice Address - Street 1:1485 FM 1960 BYPASS RD. EAST
Practice Address - Street 2:SUITE 120
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:346-377-1791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX162321835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty