Grace Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRACE MEDICAL SUPPLY LLC

Practice address

408 E Pasaro Dr
Phoenix, AZ 85085-7245

Phone

(970) 946-1146

NPI assigned

Aug 12, 2019

Last updated

Aug 12, 2019By 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

Matthew Andres

Title

Manager

Phone

(970) 946-1146

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565568000000",
    "number": "1528614096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E PASARO DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850857245",
            "telephone_number": "970-946-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E PASARO DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850857245",
            "telephone_number": "970-946-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A",
        "authorized_official_last_name": "ANDRES",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "970-946-1146"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Health Sytems LLC
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• Grace House Behavioral Health Agency Level 3
• Grace Kalt Counseling PLLC
• Grace of Serenity Living
• Grace of Serenity Living
• Grace of Serenity Living, Inc
• Grace Works Wellness Center LLC
• Amanda Simmons Grace, MD

• Durable Medical Equipment & Medical Supplies in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.