MEDICARE: GRHS, LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center	2701229R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851367486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRHS, LLC

Provider Business Mailing Address
First Line	:	360 LINDEN OAKS DRIVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2814
Country	:	US
Telephone Number	:	585-922-6200
Fax Number	:	585-922-6262

Provider Business Practice Location Address
First Line	:	360 LINDEN OAKS DRIVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2814
Country	:	US
Telephone Number	:	585-922-6200
Fax Number	:	585-922-6262

Authorized Official
Title or Position	:	EXEC DIRECTOR
Name	:	JEFF PEACOCK
Credential	:
Telephone Number	:	585-922-6201

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	05/13/2016

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