Grace Home Respiratory Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

004-00002711120-01 Issued in WI

Legal business name

GRACE HOME RESPIRATORY INC

Practice address

2204 N Hillcrest Pkwy
Suite #2
Altoona, WI 54720-2626

Phone

(715) 832-7377

Fax

(715) 832-7031

NPI assigned

Jan 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles Willis Racliff, R.R.T.

Title

President

Phone

(715) 832-7377

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Grace Home Respiratory Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grace Home Respiratory Inc

  • Durable Medical Equipment & Medical Supplies
  • Baldwin, WI
  • NPI 1023819653
  NPD tax ID

Locations

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

{
    "created_epoch": "1137196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482969600000",
    "number": "1548249899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 N HILLCREST PKWY",
            "address_2": "SUITE #2",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202626",
            "telephone_number": "715-832-7377",
            "fax_number": "715-832-7031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 N HILLCREST PKWY",
            "address_2": "SUITE #2",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547202626",
            "telephone_number": "715-832-7377",
            "fax_number": "715-832-7031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME RESPIRATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-14",
        "last_updated": "2016-12-29",
        "status": "A",
        "authorized_official_last_name": "RACLIFF",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WILLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-832-7377",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.R.T."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "004-00002711120-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41704400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Adele Galep, COTA
• Bethany Diane Geisler, CRNA
• Benjamin Foster Giertych, MD
• Jeff Goetz, D.D.S.
• Anna Lauren Graaskamp, PT, DPT
• Grace Lutheran Foundation, Inc
• Grace Lutheran Foundation, Inc.
• Grace Lutheran Foundation, Inc.
• Grace Lutheran Foundation, Inc.
• Grace Lutheran Foundation, Inc.

• Durable Medical Equipment & Medical Supplies in Altoona, WI
• Providers in Altoona, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.