Grace Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRACE MEDICAL SUPPLY LLC

Doing business as

Grace Medical Supply LLC

Practice address

203 2ND Ave S
Suite 112
Okanogan, WA 98840

Phone

(509) 557-6300

Fax

(509) 557-6380

NPI assigned

Apr 25, 2022

Last updated

Apr 25, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

JILL SCOTTAs reported in NPPES

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

Authorized official

Name

Jill ScottNPI 1912462649

Title

Owner

Phone

(509) 557-6300

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Grace Medical Supply LLC Doing business as

Electronic endpoints 1

Part of

Grace Medical Supply LLC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill Scott, OWNER

  • Durable Medical Equipment & Medical Supplies
  • Okanogan, WA
  • NPI 1912462649
  NPD Authorized official

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1073257101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E BARTLETT AVE",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419332",
            "telephone_number": "509-557-6300",
            "fax_number": "509-557-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 2ND AVE S",
            "address_2": "SUITE 112",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "98840",
            "telephone_number": "509-557-6300",
            "fax_number": "509-557-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL SUPPLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JILL SCOTT",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-10",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-557-6300"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912462649",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912462649",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@gracemedicalsupply.com",
            "affiliation": "Y",
            "endpointDescription": "DME StoreFront",
            "affiliationName": "Jill Scott",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "202 E Bartlett Ave",
            "city": "Omak",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988419332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grace Medical Supply LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Family Health Centers
• Family Health Centers Dental
• Family Health Centers Omak (Advance)
• Jessica Marie Fodge, L.M.T.
• Teresa Rene Good, RN, IBCLC
• Theodore Graham, D.D.S.
• Denny Willis Homer, DMD
• Roy Huffstetler, PA-C
• J and S Drug
• Ryann Joy Joyner, LMT

• Durable Medical Equipment & Medical Supplies in Okanogan, WA
• Providers in Okanogan, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.