Grace Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1117383 Issued in MS

Legal business name

GRACE MEDICAL SUPPLY, LLC

Practice address

655 Lake Harbour Dr Ste 1100
Ridgeland, MS 39157-4360

Phone

(769) 823-0325

NPI assigned

Jan 12, 2018

Last updated

Jan 12, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joanne Palmer

Title

Manager

Phone

(769) 823-0325

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1033627948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 LAKE HARBOUR DR STE 1100",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574360",
            "telephone_number": "769-823-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 LAKE HARBOUR DR STE 1100",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574360",
            "telephone_number": "769-823-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "769-823-0325",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "1117383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.