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Organization
GREENE MEMORIAL HOSPITAL SERVICES, INC.
Active
Organization
GREENE MEMORIAL HOSPITAL SERVICES, INC.
Active
Other names
Advanced Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY Y KO (CFO)
(937) 558-3208
Entity
Organization
Contact information
Practice address
4441 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 298-7351
(937) 298-9458
Mailing address
1 PRESTIGE PL, SUITE 550, MIAMISBURG, OH 45342-3794
(937) 762-1306
(937) 522-7626
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
213E00000X
Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2639630
—
OH
Enumeration date
10/14/2010
Last updated
09/12/2016
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