Organization
GRACE HOME RESPIRATORY INC
Active
Organization
GRACE HOME RESPIRATORY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES WILLIS RACLIFF R.R.T. (PRESIDENT)
(715) 832-7377
Entity
Organization
Contact information
Practice address
2204 N HILLCREST PKWY, SUITE #2, ALTOONA, WI 54720-2626
(715) 832-7377
(715) 832-7031
Mailing address
2204 N HILLCREST PKWY, SUITE #2, ALTOONA, WI 54720-2626
(715) 832-7377
(715) 832-7031
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
004-00002711120-01
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41704400
—
WI
Enumeration date
01/14/2006
Last updated
12/29/2016
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