MEDICARE: GREENFIELD MANAGEMENT SERVICES, INC.

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	314000000X	Skilled Nursing Facility	0100	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881743102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENFIELD MANAGEMENT SERVICES, INC.

Provider Business Mailing Address
First Line	:	4824 S LEMAY AVE
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9402
Country	:	US
Telephone Number	:	970-482-1584
Fax Number	:

Provider Business Practice Location Address
First Line	:	4824 S LEMAY AVE
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9402
Country	:	US
Telephone Number	:	970-482-1584
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE MANAGER
Name	:	MRS. DEB R. PRENTISS
Credential	:
Telephone Number	:	970-482-0198

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/14/2008

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