Organization
GRACE UDO
Active
Other names
HOLISTIC MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E UDO (OWNER/CEO)
(301) 595-3477
Entity
Organization
Contact information
Practice address
11605 EDMONSTON RD, BELTSVILLE, MD 20705-1739
(301) 595-3477
(301) 595-3466
Mailing address
11605 EDMONSTON RD, BELTSVILLE, MD 20705-1739
(301) 595-3477
(301) 595-3466
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015030400
—
MD
Enumeration date
11/03/2006
Last updated
02/13/2009
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