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Organization
GRACE HEALTHCARE MEDICAL SUPPLY, INC
Active
Organization
GRACE HEALTHCARE MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOHN WOLF (PRESIDENT)
(228) 863-3331
Entity
Organization
Contact information
Practice address
1120 BROAD AVENUE, GULFPORT, MS 39501-2414
(228) 863-3331
(228) 863-3392
Mailing address
934 TOWN SQUARE SHOPPING CENTER, SUITE 932, COLUMBIA, MS 39429-8013
(228) 863-3331
(228) 863-3392
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
06/17/2015
Last updated
08/03/2015
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