MEDICARE: GRAINGER SPEECH LANGUAGE PATHOLOGY SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	3847	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548307382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAINGER SPEECH LANGUAGE PATHOLOGY SERVICES INC

Provider Business Mailing Address
First Line	:	1928 GADDYS MILL RD
Second Line	:
City	:	HAMER
State	:	SC
Zip	:	29547-7033
Country	:	US
Telephone Number	:	843-774-7462
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 N MACARTHUR AVE
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-3434
Country	:	US
Telephone Number	:	843-774-7462
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	APRIL GRAINGER
Credential	:	MS CCC SLP
Telephone Number	:	843-774-7462

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	08/22/2020

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