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Organization

GRACE PATH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JENNIFER BOWEN RN (OWNER)
(918) 575-4849
Entity
Organization

Contact information

Practice address
12195 ELK RDG, WESLEY, AR 72773-9109
(479) 225-3505
Mailing address
12195 ELK RDG, WESLEY, AR 72773-9109
(479) 225-3505

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
332B00000X
Durable Medical Equipment & Medical Supplies
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary

Other

Enumeration date
05/30/2024
Last updated
05/30/2024
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