Provider Demographics
NPI:1619926888
Name:GRUBBS & GRUBBS INC
Entity Type:Organization
Organization Name:GRUBBS & GRUBBS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPO, CPO
Authorized Official - Phone:561-758-1945
Mailing Address - Street 1:3065 JUPITER PARK CIR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6025
Mailing Address - Country:US
Mailing Address - Phone:561-758-1945
Mailing Address - Fax:561-745-5364
Practice Address - Street 1:3065 JUPITER PARK CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6025
Practice Address - Country:US
Practice Address - Phone:561-758-1945
Practice Address - Fax:561-745-5364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR17335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL952018000Medicaid
FL1192860001Medicare ID - Type Unspecified