MEDICARE: GREEN TWP TRUSTEES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance
2	341600000X	Ambulance	02031285013	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	590015540	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000233886	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417936345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREEN TWP TRUSTEES

Provider Business Mailing Address
First Line	:	PO BOX 2065
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-7265
Country	:	US
Telephone Number	:	800-962-1484
Fax Number	:	513-527-0659

Provider Business Practice Location Address
First Line	:	6215 SPRINGFIELD XENIA RD
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45502-8142
Country	:	US
Telephone Number	:	937-324-3031
Fax Number	:	937-322-4107

Authorized Official
Title or Position	:	FISCAL OFFICER
Name	:	BRADLEY MCKEE
Credential	:
Telephone Number	:	937-206-9539

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	01/08/2026

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Directions to “GREEN TWP TRUSTEES ” Practice Location

Language	Start Address	Practice Location

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