Provider Demographics
NPI:1285183707
Name:GREENE RESPIRATORY SERVICES, INC.
Entity Type:Organization
Organization Name:GREENE RESPIRATORY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-831-0507
Mailing Address - Street 1:815 US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-9513
Mailing Address - Country:US
Mailing Address - Phone:513-831-0507
Mailing Address - Fax:513-831-4051
Practice Address - Street 1:6301 POPLAR TREE CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40228-1076
Practice Address - Country:US
Practice Address - Phone:502-272-4744
Practice Address - Fax:502-742-5617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY170385332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0401130001Medicare NSC