Provider Demographics
NPI:1033418413
Name:GRAY D SERVICES INCORPORATED
Entity type:Organization
Organization Name:GRAY D SERVICES INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-833-9449
Mailing Address - Street 1:212 HADDON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2817
Mailing Address - Country:US
Mailing Address - Phone:856-833-9449
Mailing Address - Fax:856-833-9876
Practice Address - Street 1:212 HADDON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2817
Practice Address - Country:US
Practice Address - Phone:856-833-9449
Practice Address - Fax:856-833-9876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0089400251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health