Healthcare Provider Details

I. General information

NPI: 1255946323
Provider Name (Legal Business Name): LE GRAND ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 GREENWOOD AVE STE 623
JENKINTOWN PA
19046-2651
US

IV. Provider business mailing address

590 REED RD STE 7
BROOMALL PA
19008-3654
US

V. Phone/Fax

Practice location:
  • Phone: 215-496-1307
  • Fax: 215-496-1693
Mailing address:
  • Phone: 484-420-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH A LEGRAND
Title or Position: PRESIDENT
Credential: BCO
Phone: 484-420-6779