Healthcare Provider Details

I. General information

NPI: 1730164120
Provider Name (Legal Business Name): GRANT COUNTY MEDICAL EQUIPMENT,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 N MAIN ST
ULYSSES KS
67880-2130
US

IV. Provider business mailing address

601 N MAIN ST STE B
GARDEN CITY KS
67846-5468
US

V. Phone/Fax

Practice location:
  • Phone: 620-356-1373
  • Fax: 620-356-1474
Mailing address:
  • Phone: 620-272-2660
  • Fax: 620-272-2259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number16-00101
License Number StateKS

VIII. Authorized Official

Name: BRIGITTE MARTINEZ
Title or Position: MANAGER
Credential:
Phone: 620-272-2660