# GREENE MEMORIAL HOSPITAL SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREENE MEMORIAL HOSPITAL SERVICES, INC
- **Other names:** Fairborn Family Practice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063798395
- **Legal business name:** GREENE MEMORIAL HOSPITAL SERVICES, INC
- **Authorized official:** DANIEL D HAIBACH (DIRECTOR BUSINESS DEVELOPMENT)
- **Authorized official phone:** (937) 558-3222

## Contact information

- **Practice address:** 1145 CHANNINGWAY DR, FAIRBORN, OH 45324-9244
- **Practice address phone:** (937) 878-8644
- **Practice address fax:** (937) 878-8646
- **Mailing address:** 2110 LEITER RD, MIAMISBURG, OH 45342-3660
- **Mailing address phone:** (937) 384-4838
- **Mailing address fax:** (937) 384-4845

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2011
- **Last updated:** 03/08/2012