Provider Demographics
NPI:1306503420
Name:GRAMS CARE, LLC
Entity type:Organization
Organization Name:GRAMS CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PETERSEN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-628-3263
Mailing Address - Street 1:11 BEACHWOOD W
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2817
Mailing Address - Country:US
Mailing Address - Phone:443-570-3562
Mailing Address - Fax:
Practice Address - Street 1:4124 US-17 BUS
Practice Address - Street 2:UNIT E
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-405-8174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care