Organization
PROVIDER PLUS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN GRIGGS (CEO)
(407) 206-0040
Entity
Organization
Contact information
Practice address
2512 CREEK TRAIL CT, JEFFERSON CITY, MO 65109-9245
(573) 634-0048
(573) 634-0037
Mailing address
220 W GERMANTOWN PIKE STE 250, PLYMOUTH MEETING, PA 19462-1437
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740441229
—
MO
Enumeration date
06/18/2008
Last updated
07/12/2021
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