Grace Udo

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

GRACE UDO

Doing business as

HOLISTIC MEDICAL SUPPLY

Practice address

11605 Edmonston Rd
Beltsville, MD 20705-1739

Phone

(301) 595-3477

Fax

(301) 595-3466

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David E Udo

Title

Owner/Ceo

Phone

(301) 595-3477

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HOLISTIC MEDICAL SUPPLY Doing business as

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234483200000",
    "number": "1871672725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 EDMONSTON RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051739",
            "telephone_number": "301-595-3477",
            "fax_number": "301-595-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 EDMONSTON RD",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207051739",
            "telephone_number": "301-595-3477",
            "fax_number": "301-595-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE UDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2009-02-13",
        "status": "A",
        "authorized_official_last_name": "UDO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "301-595-3477",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015030400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOLISTIC MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Goodwill Healthcare Staffing LLC
• Alicia Gopman, CRNP
• Teneille Gordon
• Kevin J Gorsline, PHARM.D
• Weyinshet P. Gossa, M.D.
• Jalayah Graham
• Mikyra Graham
• Molly Graham, LICSW
• Sofia Graham
• Claudia Grant

• Customized Equipment (DME) in Beltsville, MD
• Providers in Beltsville, MD by specialty
• Customized Equipment (DME) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2009; 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.