NPIMap

Organization Active NPI

Lady Grace Stores, Inc.

  • Prosthetic/Orthotic Supplier
  • Brookline, MA
National Provider Identifier
1265666812
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
LADY GRACE STORES, INC.
Practice address
1364 Beacon Street
Brookline, MA 02446
Phone
(617) 566-8194
NPI assigned
May 12, 2009
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Mr. Bruce Ira Green
Title
Treasurer
Phone
(781) 322-1721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X MA Primary

Addresses

Primary practice location

1364 Beacon Street
Brookline, MA 02446

Mailing address

5 Commonwealth Ave
Unit 1
Woburn, MA 01801-1009
Phone (781) 322-1721

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1364 Beacon St
Brookline, MA 02446
Phone (617) 566-8194

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1265666812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COMMONWEALTH AVE",
            "address_2": "UNIT 1",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011009",
            "telephone_number": "781-322-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 BEACON STREET",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446",
            "telephone_number": "617-566-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADY GRACE STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-322-1721",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.