# HIS GRACE MEDICAL SUPPLY AND MORE

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

## Provider details

- **NPI number:** 1871763185
- **Authorized official:** PAMELA O. ADENUGA (MANAGING EMPLOYEE)
- **Authorized official phone:** (817) 557-1668

## Contact information

- **Practice address:** 1901 SOUTHEAST PKWY, SUITE 106, ARLINGTON, TX 76018-3605
- **Practice address phone:** (817) 557-1668
- **Mailing address:** PO BOX 153202, ARLINGTON, TX 76015-9202
- **Mailing address phone:** (817) 557-1668
- **Mailing address fax:** (888) 441-6930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0100320 | TX | Yes |

## Other

- **Enumeration date:** 03/04/2008
- **Last updated:** 07/16/2009