Provider Demographics
NPI:1588872071
Name:GRAPHICA MEDICA, LLC
Entity type:Organization
Organization Name:GRAPHICA MEDICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:BFA, MS
Authorized Official - Phone:507-288-3354
Mailing Address - Street 1:328 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6505
Mailing Address - Country:US
Mailing Address - Phone:507-288-3354
Mailing Address - Fax:507-288-3431
Practice Address - Street 1:328 S BROADWAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6505
Practice Address - Country:US
Practice Address - Phone:507-288-3354
Practice Address - Fax:507-288-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND54945Medicaid
WI41703100Medicaid
MN4265090001Medicare NSC