Granger Genetics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800028179 Issued in FL

Legal business name

GRANGER GENETICS, LLC

Practice address

6784 Lake Ellenor Dr
Orlando, FL 32809-4636

Phone

(804) 915-3845

Fax

(804) 648-2641

NPI assigned

Jun 22, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Bostwick, M.B.A

Title

Owner

Phone

(804) 915-3845

Specialties & licenses 1

Addresses

Tax ID family

Granger Genetics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Granger Genetics, LLC

  • Compounding Pharmacy
  • North Chesterfield, VA
  • NPI 1689252744
  NPD tax ID

Locations

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1740631605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BIOTECH DR",
            "address_2": "SUITE 301",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355167",
            "telephone_number": "804-915-3845",
            "fax_number": "804-648-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6784 LAKE ELLENOR DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328094636",
            "telephone_number": "804-915-3845",
            "fax_number": "804-648-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGER GENETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "BOSTWICK",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-915-3845",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.B.A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800028179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Axis International LLC
• Grand Palms Alf Operator LLC
• Gowtham Rama Harsha Grandhi, MBBS, MPH
• Caio Rotondo Grandi
• Odelvys Granela, DO
• Elizabeth Michelle Granger, MS, CCC-SLP
• Lindsey Leigh Granger, ARNP
• Kaye-Ann Grant-Taylor, RD
• Arlene W Grant, PHARMACIST
• Carol R Grant, MD LLC

• Clinical Medical Laboratory in Orlando, FL
• Providers in Orlando, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.