Provider Demographics
NPI:1477674455
Name:GRADY MAGURES, INC
Entity Type:Organization
Organization Name:GRADY MAGURES, INC
Other - Org Name:AMPLEX HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRADY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAGURES
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DISPENSE
Authorized Official - Phone:916-486-2581
Mailing Address - Street 1:2717 EL CAMINO AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-5903
Mailing Address - Country:US
Mailing Address - Phone:916-486-2581
Mailing Address - Fax:916-486-2582
Practice Address - Street 1:2717 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-5903
Practice Address - Country:US
Practice Address - Phone:916-486-2581
Practice Address - Fax:916-486-2582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA11237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ74517ZMedicaid