Provider Demographics
NPI:1124727953
Name:GRANT SENIOR CARE
Entity type:Organization
Organization Name:GRANT SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-248-2444
Mailing Address - Street 1:PO BOX 772
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29528-0772
Mailing Address - Country:US
Mailing Address - Phone:843-248-2444
Mailing Address - Fax:843-248-2175
Practice Address - Street 1:311 BEATY ST STE A
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-5051
Practice Address - Country:US
Practice Address - Phone:843-248-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care