Organization
GRANDVILLE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE G BELL (PRESIDENT)
(916) 224-5352
Entity
Organization
Contact information
Practice address
8521 DEWBERRY WAY, ELK GROVE, CA 95624-1246
(961) 224-5352
Mailing address
8521 DEWBERRY WAY, ELK GROVE, CA 95624-1246
(961) 224-5352
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
143763
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MTN01205G
—
CA
Enumeration date
01/02/2008
Last updated
02/16/2012
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