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General NPI Number Information
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NPI Number | 1033360128
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Entity Type | Organization
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Legal Business Name | GRANT PHARMACISTS GROUP
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 105 SPEARS LN
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City | CRITTENDEN
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State | KY
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Zip | 41030-7513
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Country | US
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Telephone | 185-942-8090
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Fax | 185-981-3132
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Provider Business Mailing Address
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Address Line | 105 SPEARS LN
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City | CRITTENDEN
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State | KY
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Zip | 41030-7513
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Country | US
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Telephone | 185-942-8090
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Fax | 185-981-3132
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Authorized Official
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Title or Position | MEDICAL RECORDS CLERK
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Name | MRS. LISA G WILLIAMSON
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Credential |
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Telephone | 16068453421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | P07274
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License Number State | KY
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