Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1518454602 |
| LBN Legal business name | BREATHE GRACE MEDICAL SUPPLY, LLC |
| Authorized official | WENDY RUSSALESI - (CCO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 04/16/2018 |
| Last updated | 10/13/2025 - About 8 months ago |
| Identifiers | n/a |
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