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General NPI Number Information
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NPI Number | 1598797342
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Entity Type | Organization
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Legal Business Name | PAT GRIMES, INC.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 2303 JEFFERSON DAVIS HWY
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-2115
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Country | US
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Telephone | 540-371-9181
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Fax | 540-899-6461
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Provider Business Mailing Address
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Address Line | PO BOX 786
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City | FREDERICKSBURG
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State | VA
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Zip | 22404-0786
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Country | US
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Telephone | 540-371-9181
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Fax | 540-899-6461
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KIRKLYN STRATTON HUMPHREYS
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Credential |
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Telephone | 540-371-9181
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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 | 0206008999
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License Number State | VA
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