Provider Demographics
NPI:1760803258
Name:GRANT SMITH INSURANCE AGENCY, LLC
Entity Type:Organization
Organization Name:GRANT SMITH INSURANCE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT AND OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-613-3229
Mailing Address - Street 1:800 LOMB AVE SW STE F
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1200
Mailing Address - Country:US
Mailing Address - Phone:205-613-3229
Mailing Address - Fax:205-868-3902
Practice Address - Street 1:800 LOMB AVE SW STE F
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1200
Practice Address - Country:US
Practice Address - Phone:205-613-3229
Practice Address - Fax:205-868-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0297637171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty