Gradam Men's Health Testosterone Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GRADAM MEN'S HEALTH TESTOSTERONE CLINIC LLC

Practice address

225 Newman Ave
Rumford, RI 02916-1218

Phone

(401) 599-3737

Fax

(401) 409-5545

NPI assigned

Jan 20, 2025

Last updated

Jan 20, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Charlie O Imonah, APRN, DNP, FNP

Title

Medical Director

Phone

(401) 599-3737

Specialties & licenses 1

Addresses

Other names 1

• Gradam Dispatching Services LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1083425854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NEWMAN AVE",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161218",
            "telephone_number": "401-599-3737",
            "fax_number": "401-409-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NEWMAN AVE",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161218",
            "telephone_number": "401-599-3737",
            "fax_number": "401-409-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADAM MEN'S HEALTH TESTOSTERONE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A",
        "authorized_official_last_name": "IMONAH",
        "authorized_official_first_name": "CHARLIE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "401-599-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "APRN, DNP, FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gradam Dispatching Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Rachel Nicole Frady
• Fyd LLC (Olive Home Care Services)
• Leah Garvey, M.S., CCC-SLP
• Julia Gaw
• Arthur Gary Georgeu, D.M.D.
• Guardian Grace Private Home Care
• Audrey Elaine Hall
• Mary Elisabeth Hannah, M.S.ED, BCBA
• Courtney Heck, OTR/L
• Lisa Helgerson

• Clinic/Center in Rumford, RI
• Providers in Rumford, RI by specialty
• Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.