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General NPI Number Information
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NPI Number | 1417407735
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Entity Type | Organization
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Legal Business Name | GREENE RESPIRATORY SERVICES, INC.
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 10/11/2016
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Provider Practice Location Address
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Address Line | 211 4TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1221
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Country | US
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Telephone | 304-908-5414
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Fax | 681-378-3566
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Provider Business Mailing Address
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Address Line | 815 US HIGHWAY 50
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City | MILFORD
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State | OH
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Zip | 45150-9513
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Country | US
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Telephone | 513-831-0507
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Fax | 513-831-4051
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Authorized Official
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Title or Position | CFO
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Name | MR. STEPHEN RUSSELL
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Credential |
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Telephone | 513-831-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 000084229-0
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License Number State | WV
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