# GRACEFUL MEDICAL SUPPLY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407333719
- **Authorized official:** JAMIE NELSON (OWNER)
- **Authorized official phone:** (813) 315-8625

## Contact information

- **Practice address:** 220 W BRANDON BLVD STE 206, BRANDON, FL 33511-5100
- **Practice address phone:** (813) 315-8625
- **Mailing address:** 220 W BRANDON BLVD STE 206, BRANDON, FL 33511-5100
- **Mailing address phone:** (813) 315-8625

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/20/2018
- **Last updated:** 03/02/2019