MEDICARE: SANDRA L GRUBB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN 133556 IV	OH

General Provider Information

NPI Number	:	1063729838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA L GRUBB

Provider Business Mailing Address
First Line	:	2105 SIDNEYWOOD DR APT D
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-2651
Country	:	US
Telephone Number	:	937-204-2043
Fax Number	:

Provider Business Practice Location Address
First Line	:	2105 SIDNEYWOOD DR APT D
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-2651
Country	:	US
Telephone Number	:	937-204-2043
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	06/28/2025

Similar Medicare Providers

1750225587 — SYNCTAX LLC
Practice Location Address:

2775 ORCHARD RUN RD
DAYTON, OH
45449-2831

Practice Phone: 330-843-0180
Practice Fax:

1730021239 — ZEERAK MTI LLC
Practice Location Address:

2775 ORCHARD RUN RD
DAYTON, OH
45449-2831

Practice Phone: 913-204-0167
Practice Fax:

1326980020 — MR. AHMED ZAKARIA GUEZOUZ
Practice Location Address:

532 LUDWELL PL
DAYTON, OH
45449-2473

Practice Phone: 929-435-0878
Practice Fax:

1891637500 — CARRYON TRANSPORTATION LLC
Practice Location Address:

532 LUDWELL PL
DAYTON, OH
45449-2473

Practice Phone: 929-435-0878
Practice Fax:

1467395848 — SPECTECH SERVICES LLC
Practice Location Address:

2775 ORCHARD RUN RD
DAYTON, OH
45449-2831

Practice Phone: 331-321-9723
Practice Fax:

1629071337 — DR. AUGUSTO L MARTINEZ M.D.
Practice Location Address:

5932 SPRINGBORO PIKE
DAYTON, OH
45449-3250

Practice Phone: 937-435-8663
Practice Fax: 937-435-8966

Directions to “ SANDRA L GRUBB ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.