Organization Name: | GRACE MEDICAL LLC |
NPI Number: | 1295755130 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN C LORE (OWNER/PRESIDENT) |
Mailing Address: | 711 N Main St Unit 13 Pleasantville |
State: | NJ US |
Postal Code: | 082321590 |
Phone Number: | 6099093722 |
Fax Number: | 6099092861 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |