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General NPI Number Information
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NPI Number | 1336380708
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Entity Type | Organization
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Legal Business Name | GRANVILLE HEALTH INC
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 102 PROFESSIONAL PARK SUITE C
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City | OXFORD
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State | NC
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Zip | 27565-2501
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Country | US
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Telephone | 919-690-0435
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Fax | 252-492-2028
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | OXFORD
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State | NC
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Zip | 27565-0986
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Country | US
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Telephone | 919-690-0435
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Fax | 252-492-2028
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Authorized Official
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Title or Position | CFO
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Name | JAMIE PURVIS
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Credential |
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Telephone | 919-690-3237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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