| Organization Name: | GRAYBEARD CONSTRUCTION LLC |
| NPI Number: | 1275822967 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY GULEN (PRESIDENT) |
| Mailing Address: | 1158 Cornwallis Way Collegeville |
| State: | PA US |
| Postal Code: | 194261887 |
| Phone Number: | 6109455507 |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2011 |
| NPI Last Update Date: | 04/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | PA066873 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |