Grace Healthcare Laboratory, Inc.

LBN: Grace Healthcare Laboratory, Inc.
Grace Healthcare Laboratory, Inc. is an health care organization with primary practice located at 1120 Broad Ave , Gulfport MS 39501-2414. The organization recently has only one registered license in Laboratories / Clinical Medical Laboratory, which is considered as the primary health care specialty. Grace Healthcare Laboratory, Inc. can be contacted via phone (228) 863-3331, or through Wolf, David via phone (228) 863-3331.

Contact Information

Primary practice address
1120 Broad Ave Gulfport MS 39501-2414
Phone: (228) 863-3331
Fax: (228) 863-3392
Website:
Map and Directions
Authorized official contact:
Name: Wolf, David
Phone: (228) 863-3331

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X

Profile Details

NPI number 1275531261
LBN Legal business name Grace Healthcare Laboratory, Inc.
DBA Doing business as
Authorized official Wolf, David
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2005
Last updated Dec 31st, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275531261 NPPES
Mississippi MEDICAID 09752571

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