Provider Demographics
NPI:1801919279
Name:E. GRAM SOLUTIONS, INC
Entity type:Organization
Organization Name:E. GRAM SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEIRDRE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, CCC-SLP
Authorized Official - Phone:919-606-4559
Mailing Address - Street 1:4612 HOE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2482
Mailing Address - Country:US
Mailing Address - Phone:919-606-4559
Mailing Address - Fax:910-565-3676
Practice Address - Street 1:4612 HOE CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2482
Practice Address - Country:US
Practice Address - Phone:919-606-4559
Practice Address - Fax:910-565-3676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:E. GRAM SOLUTIONS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-09
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211969Medicaid