Provider Demographics
NPI:1962156026
Name:GRACE FREIGHT LLC
Entity type:Organization
Organization Name:GRACE FREIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-828-1769
Mailing Address - Street 1:14029 KNIGHTSBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-8492
Mailing Address - Country:US
Mailing Address - Phone:901-828-1769
Mailing Address - Fax:
Practice Address - Street 1:14029 KNIGHTSBRIDGE LN
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8492
Practice Address - Country:US
Practice Address - Phone:901-828-1769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)