Provider Demographics
NPI:1962398461
Name:GRANITE DME, LLC
Entity type:Organization
Organization Name:GRANITE DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-750-9971
Mailing Address - Street 1:14932 ROLLOVER PASS LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-1256
Mailing Address - Country:US
Mailing Address - Phone:469-750-9971
Mailing Address - Fax:214-291-2648
Practice Address - Street 1:3140 LEGACY DR STE 320
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9383
Practice Address - Country:US
Practice Address - Phone:469-750-9971
Practice Address - Fax:214-291-2648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies