Provider Demographics
NPI:1174792436
Name:DRS. GRIFFITH & GRIFFITH, LLC
Entity type:Organization
Organization Name:DRS. GRIFFITH & GRIFFITH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:575-885-4030
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88221-0369
Mailing Address - Country:US
Mailing Address - Phone:575-885-4030
Mailing Address - Fax:
Practice Address - Street 1:101 S MESQUITE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5746
Practice Address - Country:US
Practice Address - Phone:575-885-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM338332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0653670001Medicare NSC
NM525155994Medicare PIN