Provider Demographics
NPI:1598015018
Name:GREYSTONE HOSPICE OF OHIO LLC
Entity Type:Organization
Organization Name:GREYSTONE HOSPICE OF OHIO LLC
Other - Org Name:GREYSTONE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-635-9500
Mailing Address - Street 1:500 W. WILSON BRIDGE ROAD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2238
Mailing Address - Country:US
Mailing Address - Phone:614-310-3772
Mailing Address - Fax:614-310-3777
Practice Address - Street 1:500 W. WILSON BRIDGE RD.
Practice Address - Street 2:SUITE 314
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2238
Practice Address - Country:US
Practice Address - Phone:614-310-3772
Practice Address - Fax:614-310-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0107469Medicaid
OH0107469Medicaid