Provider Demographics
NPI:1437843117
Name:GRISBY CONTRACTING LLC
Entity Type:Organization
Organization Name:GRISBY CONTRACTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GRISBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-726-0148
Mailing Address - Street 1:7331 S MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-3032
Mailing Address - Country:US
Mailing Address - Phone:773-726-0148
Mailing Address - Fax:
Practice Address - Street 1:7331 S MOZART ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-3032
Practice Address - Country:US
Practice Address - Phone:773-726-0148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)