Provider Demographics
NPI:1225829765
Name:GRACEWELL INC
Entity type:Organization
Organization Name:GRACEWELL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:AQEEL
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-627-6785
Mailing Address - Street 1:2201 COOPERATIVE WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2201 COOPERATIVE WAY STE 600
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3005
Practice Address - Country:US
Practice Address - Phone:703-627-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment