Healthcare Provider Details
I. General information
NPI: 1689615460
Provider Name (Legal Business Name): GREENE RESPIRATORY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2006
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
55 W TECHNE CENTER DR
MILFORD OH
45150-8901
US
IV. Provider business mailing address
815 US HIGHWAY 50
MILFORD OH
45150-9513
US
V. Phone/Fax
- Phone: 513-831-0507
- Fax: 513-831-4051
- Phone: 513-831-0507
- Fax: 513-831-4051
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | HMER 22038 |
| License Number State | OR |
VIII. Authorized Official
Name: MR.
TONY
ESCAMILLA
Title or Position: PRESIDENT
Credential:
Phone: 513-831-0507