NPIMap

Organization Active NPI

Lady Grace Stores, Inc.

  • Prosthetic/Orthotic Supplier
  • Waltham, MA
National Provider Identifier
1265669477
Registry record updated Jun 15, 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
108 River St
Waltham, MA 02453-8306
Phone
(781) 894-2081
NPI assigned
Jun 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Authorized official

Name
Bruce I Green
Title
Treasurer
Phone
(781) 322-1721

Specialties & licenses 1

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

Addresses

Primary practice location

108 River St
Waltham, MA 02453-8306

Mailing address

108 River St
Waltham, MA 02453-8306
Phone (781) 894-2081

National Provider Directory

National Provider Directory

Member of 1

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

Locations

108 River St
Waltham, MA 02453
Phone (781) 894-2081

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1265669477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 RIVER ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024538306",
            "telephone_number": "781-894-2081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 RIVER ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024538306",
            "telephone_number": "781-894-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LADY GRACE STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "781-322-1721"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.