Provider Demographics
NPI:1699001123
Name:GRAY FLEX INC
Entity Type:Organization
Organization Name:GRAY FLEX INC
Other - Org Name:GRACE MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-790-8270
Mailing Address - Street 1:11321 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-7808
Mailing Address - Country:US
Mailing Address - Phone:562-790-8270
Mailing Address - Fax:
Practice Address - Street 1:11321 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-7808
Practice Address - Country:US
Practice Address - Phone:562-790-8270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)