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Grace Healthcare Medical Supply, Inc

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Company Details

Name: Grace Healthcare Medical Supply, Inc
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 27 Apr 2015 (10 years ago)
Business ID: 1066110
ZIP code: 39429
County: Marion
State of Incorporation: MISSISSIPPI
Principal Office Address: 924 Hwy 13 SouthColumbia, MS 39429

Agent

Name Role Address
David John Wolf Agent 1120 Broad Ave, Gulfport, MS 39501

Incorporator

Name Role Address
David John Wolf Incorporator 1223 Old Hwy 98 E, Columbia, MS 39429

Director

Name Role Address
David J Wolf Director 1120 Broad Ave, Gulfport, MS 39501

President

Name Role Address
David J Wolf President 1120 Broad Ave, Gulfport, MS 39501

National Provider Identifier

NPI Number:
1215318035

Authorized Person:

Name:
MR. DAVID JOHN WOLF
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
332BX2000X - Oxygen Equipment & Supplies (DME)
Is Primary:
Yes

Contacts:

Fax:
2288633392

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2017-12-06 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2017-09-06 Notice to Dissolve/Revoke
Annual Report Filed 2016-04-06 Annual Report For Grace Healthcare Medical Supply, Inc
Amendment Form Filed 2015-07-20 Amendment For Grace Healthcare Medical Supply, Inc
Amendment Form Filed 2015-04-27 Amendment For Grace Healthcare Medical Supply, Inc
Formation Form Filed 2015-04-27 Formation For Grace Healthcare Medical Supply, Inc

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Date of last update: 03 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website