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Organization

GRACE MEDICAL SUPPLY LLC

Active
Parent organization
JILL SCOTT
Other names
Grace Medical Supply LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
JILL SCOTT
Authorized official
JILL SCOTT (OWNER)
(509) 557-6300
Entity
Organization

Contact information

Practice address
203 2ND AVE S, SUITE 112, OKANOGAN, WA 98840
(509) 557-6300
(509) 557-6380
Mailing address
202 E BARTLETT AVE, OMAK, WA 98841-9332
(509) 557-6300
(509) 557-6380

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BC3200X
Customized Equipment (DME)
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1912462649
NPI
WA
05
1912462649
WA
Enumeration date
04/25/2022
Last updated
04/25/2022
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