Provider Demographics
NPI:1902164650
Name:GRINBATH, LLC
Entity Type:Organization
Organization Name:GRINBATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:866-931-9418
Mailing Address - Street 1:2321 50TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-2563
Mailing Address - Country:US
Mailing Address - Phone:866-931-9418
Mailing Address - Fax:
Practice Address - Street 1:2321 50TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2563
Practice Address - Country:US
Practice Address - Phone:866-931-9418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment