# ICGRIT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053921353
- **Authorized official:** ROBERT SULLIVAN SALONE COPO (PRESIDENT)
- **Authorized official phone:** (661) 874-8888

## Contact information

- **Practice address:** 42304 COLUMBIA COURT, LANCASTER, CA 93536
- **Practice address phone:** (805) 217-0252
- **Mailing address:** 22543 VENTURA BLVD STE 220, WOODLAND HILLS, CA 91364-1403
- **Mailing address phone:** (805) 217-0252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/03/2020
- **Last updated:** 08/03/2020