1467432690 NPI number — THE GRAEBER CORPORATION

Table of content: (NPI 1467432690)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467432690 NPI number — THE GRAEBER CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE GRAEBER CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIABETIC SUPPLY OF GRACO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467432690
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
914 E GARRISON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GASTONIA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28054-4571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
914 E GARRISON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GASTONIA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28054-4571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-824-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRAEBER
Authorized Official First Name:
HANNA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
704-824-6000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009604580 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7701563 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0584219 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200095560A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003110864 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010093333 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9159970 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2007876 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90052523 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 128633741 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4581898 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME965 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00697837A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200017060A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00440372 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 172800800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7265213 TYPE 57 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: MS714NC , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".




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