Provider Demographics
NPI:1740750140
Name:GREEN HILLS MANAGEMENT INC.
Entity Type:Organization
Organization Name:GREEN HILLS MANAGEMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-879-8935
Mailing Address - Street 1:325 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-3803
Mailing Address - Country:US
Mailing Address - Phone:931-638-1530
Mailing Address - Fax:
Practice Address - Street 1:1009 N LOCUST AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2746
Practice Address - Country:US
Practice Address - Phone:931-766-2622
Practice Address - Fax:931-766-2632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center