Granny'S Pantry Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRANNY'S PANTRY INC

Practice address

1666 N Hampton Rd Ste 200
Desoto, TX 75115-8622

Phone

(214) 334-1812

NPI assigned

Nov 9, 2021

Organization subpart

No

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

Authorized official

Name

Jessica McCullough

Title

Director/Ceo

Phone

(214) 334-1812

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1679239263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1666 N HAMPTON RD STE 200",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1666 N HAMPTON RD STE 200",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158622",
            "telephone_number": "214-334-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANNY'S PANTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "214-334-1812"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Desoto, TX
• Providers in Desoto, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.