1033413935 NPI number — GREENE MEMORIAL HOSPITAL SERVICES, INC.

Table of content: (NPI 1033413935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033413935 NPI number — GREENE MEMORIAL HOSPITAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREENE MEMORIAL HOSPITAL SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033413935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PRESTIGE PL
Provider Second Line Business Mailing Address:
SUITE 550
Provider Business Mailing Address City Name:
MIAMISBURG
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45342-3794
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-762-1306
Provider Business Mailing Address Fax Number:
937-522-7626

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2510 COMMONS BLVD
Provider Second Line Business Practice Location Address:
SUITE 160
Provider Business Practice Location Address City Name:
BEAVERCREEK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45431-3820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-298-7351
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KO
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
Y
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
937-558-3208

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com