Provider Demographics
NPI:1770751604
Name:GREENE MEMORIAL HOSPITAL SERVICES INC
Entity type:Organization
Organization Name:GREENE MEMORIAL HOSPITAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICIAN PRACTICES
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DRENTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-352-2788
Mailing Address - Street 1:1141 N MONROE DR
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1619
Mailing Address - Country:US
Mailing Address - Phone:937-352-2787
Mailing Address - Fax:937-352-3788
Practice Address - Street 1:3359 KEMP RD
Practice Address - Street 2:STE. 240
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2565
Practice Address - Country:US
Practice Address - Phone:937-458-4630
Practice Address - Fax:937-458-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2639630Medicaid
OH5968920001OtherDME
OH9273677Medicare PIN