Provider Demographics
NPI:1780185504
Name:THE GRIFFIN AND BLOUNT GROUP, LLC
Entity Type:Organization
Organization Name:THE GRIFFIN AND BLOUNT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROGENIA
Authorized Official - Middle Name:SHANTELL
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-439-8067
Mailing Address - Street 1:25 WYNFIELD KEEP
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-2559
Mailing Address - Country:US
Mailing Address - Phone:470-439-8067
Mailing Address - Fax:
Practice Address - Street 1:25 WYNFIELD KEEP
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-2559
Practice Address - Country:US
Practice Address - Phone:470-439-8067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health