Provider Demographics
NPI:1255954541
Name:GRIGG, STEPHEN JOHN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOHN
Last Name:GRIGG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:ME
Mailing Address - Zip Code:04048-0276
Mailing Address - Country:US
Mailing Address - Phone:207-468-8210
Mailing Address - Fax:
Practice Address - Street 1:69 WATSON HILL RD
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:ME
Practice Address - Zip Code:04048-3110
Practice Address - Country:US
Practice Address - Phone:207-468-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care