Provider Demographics
NPI:1548884570
Name:STEPHEN GRIGG
Entity type:Organization
Organization Name:STEPHEN GRIGG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-468-8210
Mailing Address - Street 1:PO BOX 276
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:ME
Mailing Address - Zip Code:04048-0276
Mailing Address - Country:US
Mailing Address - Phone:207-468-8210
Mailing Address - Fax:
Practice Address - Street 1:69 WATSON HILL RD
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:ME
Practice Address - Zip Code:04048
Practice Address - Country:US
Practice Address - Phone:207-468-8210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care