Provider Demographics
NPI:1689615460
Name:GREENE RESPIRATORY SERVICES, INC
Entity Type:Organization
Organization Name:GREENE RESPIRATORY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCAMILLA
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 1:55 W TECHNE CENTER DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8901
Practice Address - Country:US
Practice Address - Phone:513-831-0507
Practice Address - Fax:513-831-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
ORHMER 22038332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90003765Medicaid
OH0917780Medicaid
KY90003765Medicaid