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General NPI Number Information
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NPI Number | 1073441804
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Entity Type | Organization
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Legal Business Name | GRAND RIVER MOBILITY LLC
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 923 GARFIELD AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-4022
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Country | US
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Telephone | 313-505-7532
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Fax | 313-505-7532
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Provider Business Mailing Address
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Address Line | 923 GARFIELD AVE NW
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-4022
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Country | US
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Telephone | 313-505-7532
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Fax | 313-505-7532
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL DELUCA
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Credential |
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Telephone | 313-505-7532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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