Provider Demographics
NPI:1386998987
Name:GRASEE, INC.
Entity type:Organization
Organization Name:GRASEE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCKIMMIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-586-9507
Mailing Address - Street 1:556 WINDMILL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LEONARD
Mailing Address - State:MD
Mailing Address - Zip Code:20685-2565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:23191 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-6024
Practice Address - Country:US
Practice Address - Phone:301-863-6080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-04
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty