Organization
GRACE HEALTHCARE DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J WOLF (PRESIDENT)
(228) 863-3331
Entity
Organization
Contact information
Practice address
300 HIGHWAY 11, SUITE D, POPLARVILLE, MS 39470
(601) 240-0001
Mailing address
1120 BROAD AVENUE, GULFPORT, MS 39501
(228) 863-3331
(228) 863-3392
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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