Provider Demographics
NPI:1902543291
Name:ARLENE GRAY ENTERPRISES, LLC
Entity Type:Organization
Organization Name:ARLENE GRAY ENTERPRISES, LLC
Other - Org Name:OGP MEDICAL WIGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CRANIAL PROSTHESIS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-272-5088
Mailing Address - Street 1:200 E ROBINSON ST STE 1120
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1962
Mailing Address - Country:US
Mailing Address - Phone:407-839-6215
Mailing Address - Fax:407-839-6216
Practice Address - Street 1:200 E ROBINSON ST STE 1120
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1962
Practice Address - Country:US
Practice Address - Phone:407-839-6215
Practice Address - Fax:407-839-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies