Provider Demographics
NPI:1114601606
Name:GRAMERCY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:GRAMERCY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADENIYI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-269-6946
Mailing Address - Street 1:3959 DUNCAN IVES DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7599
Mailing Address - Country:US
Mailing Address - Phone:470-269-6946
Mailing Address - Fax:
Practice Address - Street 1:3959 DUNCAN IVES DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7599
Practice Address - Country:US
Practice Address - Phone:470-269-6946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health