Provider Demographics
NPI:1467432690
Name:THE GRAEBER CORPORATION
Entity Type:Organization
Organization Name:THE GRAEBER CORPORATION
Other - Org Name:DIABETIC SUPPLY OF GRACO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-824-6000
Mailing Address - Street 1:914 E GARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:914 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4571
Practice Address - Country:US
Practice Address - Phone:704-824-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009604580Medicaid
NC7701563Medicaid
IA0584219Medicaid
IN200095560AMedicaid
CT003110864Medicaid
VA010093333Medicaid
SD9159970Medicaid
OH2007876Medicaid
KY90052523Medicaid
AR128633741Medicaid
TN4581898Medicaid
SCDME965Medicaid
GA00697837AMedicaid
OK200017060AMedicaid
MS00440372Medicaid
MD172800800Medicaid
PA7265213 TYPE 57Medicaid
AKMS714NCMedicaid
SCDME965Medicaid