Organization
GRANT STATE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIVY RODRIGUEZ CRESPO (OWNER)
(954) 534-7530
Entity
Organization
Contact information
Practice address
2500 EAST HALLANDALE BEACH BLVD, FL 9 PH5, HALLANDALE, FL 33009
(954) 534-7530
Mailing address
2500 EAST HALLANDALE BEACH BLVD, FL 9 PH5, HALLANDALE, FL 33009
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
01/20/2023
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