Healthcare Provider Details

I. General information

NPI: 1225829765
Provider Name (Legal Business Name): GRACEWELL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 COOPERATIVE WAY STE 600
HERNDON VA
20171-3005
US

IV. Provider business mailing address

2201 COOPERATIVE WAY STE 600
HERNDON VA
20171-3005
US

V. Phone/Fax

Practice location:
  • Phone: 703-788-6894
  • Fax: 703-788-6872
Mailing address:
  • Phone: 703-788-6894
  • Fax: 703-788-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD AQEEL BHATTI
Title or Position: OWNER
Credential:
Phone: 703-627-6785