Organization
GRACE MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW ANDRES (MANAGER)
(970) 946-1146
Entity
Organization
Contact information
Practice address
408 E PASARO DR, PHOENIX, AZ 85085-7245
(970) 946-1146
Mailing address
408 E PASARO DR, PHOENIX, AZ 85085-7245
(970) 946-1146
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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