Organization
GRANTHAM FAMILY CARE HOME 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES L GRANTHAM (OWNER)
(919) 735-2121
Entity
Organization
Contact information
Practice address
107 N GEORGIA AVE, GOLDSBORO, NC 27530-3531
(919) 735-2121
Mailing address
301 S JOHN ST, GOLDSBORO, NC 27530-3531
(919) 735-2121
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
FCL096009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7802189
—
NC
Enumeration date
01/03/2008
Last updated
06/26/2008
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