Provider Demographics
NPI:1164300851
Name:GRANT MEDICAL CONSULTING LLC
Entity type:Organization
Organization Name:GRANT MEDICAL CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-508-5677
Mailing Address - Street 1:5580 THOMASTON RD STE 18
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31220-8121
Mailing Address - Country:US
Mailing Address - Phone:478-207-9651
Mailing Address - Fax:404-856-0692
Practice Address - Street 1:8735 DUNWOODY PL # 10492
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-2995
Practice Address - Country:US
Practice Address - Phone:478-207-9651
Practice Address - Fax:404-856-0692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory