Provider Demographics
NPI:1275410102
Name:DANITRON LLC
Entity type:Organization
Organization Name:DANITRON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANTICLEER
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-793-0677
Mailing Address - Street 1:4751 BEST RD STE 392
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30337-5615
Mailing Address - Country:US
Mailing Address - Phone:404-793-0677
Mailing Address - Fax:
Practice Address - Street 1:4751 BEST RD STE 392
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30337-5615
Practice Address - Country:US
Practice Address - Phone:404-793-0677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHCP042855OtherPERSNOAL HOME CARE PROVIDER