Provider Demographics
NPI:1194994970
Name:GRACE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:GRACE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ONUOHA
Authorized Official - Middle Name:O
Authorized Official - Last Name:CHUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-847-8845
Mailing Address - Street 1:183 WIND CHIME CT STE 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6473
Mailing Address - Country:US
Mailing Address - Phone:919-847-8845
Mailing Address - Fax:919-847-8635
Practice Address - Street 1:183 WIND CHIME CT STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6473
Practice Address - Country:US
Practice Address - Phone:919-847-8845
Practice Address - Fax:919-847-8635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies