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General NPI Number Information
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NPI Number | 1609135896
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Entity Type | Organization
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Legal Business Name | GRAYCO INC.
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | LOCAL 2517 AVE. BOULEVARD LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-261-8900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 862
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City | SABANA SECA
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State | PR
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Zip | 00952-0862
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | JOSE A NEGRON ORTEGA
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Credential |
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Telephone | 787-261-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1256
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License Number State | PR
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