Grace Home Testing Inc

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

GRACE HOME TESTING INC

Practice address

1120 Broad Ave
Gulfport, MS 39501-2414

Phone

(228) 863-3331

Fax

(228) 863-3392

NPI assigned

Feb 18, 2013

Last updated

Feb 18, 2013By 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. David Wolf

Title

President

Phone

(228) 863-3331

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1361145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361145600000",
    "number": "1275873986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012414",
            "telephone_number": "228-863-3331",
            "fax_number": "228-863-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012414",
            "telephone_number": "228-863-3331",
            "fax_number": "228-863-3392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME TESTING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-18",
        "last_updated": "2013-02-18",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "228-863-3331",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy M Goulet, D.C.
• GPCH-GP, Inc. (Garden Park Medical Center)
• GPCH-GP, Inc. (Garden Park Medical Center)
• Grace Healthcare Laboratory, Inc.
• Grace Healthcare Medical Supply, Inc
• Grace Medical Equipment Inc (Grace Healthcare)
• Graceful Pathways Inc
• Grady Consulting Services, LLC
• John Nolan Grady, M.D.
• Anisia Graham

• Physiological Laboratory in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Physiological Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; 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.