Provider Demographics
NPI:1861867392
Name:GRANT MEDICAL LLC
Entity Type:Organization
Organization Name:GRANT MEDICAL LLC
Other - Org Name:ROXBORO SLEEP CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:919-455-4407
Mailing Address - Street 1:1017 TENDER DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-2405
Mailing Address - Country:US
Mailing Address - Phone:919-455-4407
Mailing Address - Fax:877-360-7338
Practice Address - Street 1:201B S MADISON BLVD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5461
Practice Address - Country:US
Practice Address - Phone:919-455-4407
Practice Address - Fax:877-360-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic