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NPI Code Detail

MEDICARE: GRGICH PC

MEDICARE: GRGICH PC
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
1103T00000XPsychologistPYO413NV

General Provider Information

NPI Number : 1255635421
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRGICH PC
Provider Business Mailing Address
First Line : 1601 E BASIN
Second Line : SUITE 302
City : PAHRUMP
State : NV
Zip : 89048-4612
Country : US
Telephone Number : 775-751-1349
Fax Number :
Provider Business Practice Location Address
First Line : 1601 E BASIN AVE
Second Line : SUITE 302
City : PAHRUMP
State : NV
Zip : 89060-4611
Country : US
Telephone Number : 775-751-1349
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BECKIE GRGICH
Credential : PSYD
Telephone Number : 775-751-1349
Provider Enumeration Date : 01/03/2011
Last Update Date : 01/03/2011

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Directions to “GRGICH PC ” Practice Location

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