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Organization

GRACE HEALTHCARE DME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID J WOLF (PRESIDENT)
(228) 863-3331
Entity
Organization

Contact information

Practice address
112 S 27TH AVE, HATTIESBURG, MS 39401-7156
(228) 263-3331
Mailing address
1120 BROAD AVE, GULFPORT, MS 39501-2414

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
08651/11.1
MS

Other

Enumeration date
04/12/2017
Last updated
04/12/2017
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