Organization
FAITH & GRACE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LA JUETA PAULK (VICE PRESIDENT/CFO)
(661) 946-3161
Entity
Organization
Contact information
Practice address
44134 CAMELLIA ST, LANCASTER, CA 93535
(661) 946-3161
Mailing address
44134 CAMELLIA ST, LANCASTER, CA 93535
(661) 946-3161
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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