# EDGEWATER GOLF INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EDGEWATER GOLF INC.
- **Other names:** Green Wolf Transportation
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649884123
- **Legal business name:** EDGEWATER GOLF INC.
- **Authorized official:** MS. DIANE M SIMMS (PRESIDENT)
- **Authorized official phone:** (330) 771-4830

## Contact information

- **Practice address:** 2401 FOX AVE SE, MINERVA, OH 44657-9146
- **Practice address phone:** (330) 771-4830
- **Practice address fax:** (330) 862-2510
- **Mailing address:** 2401 FOX AVE SE, MINERVA, OH 44657-9146
- **Mailing address phone:** (330) 771-4830
- **Mailing address fax:** (330) 862-2510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 347E00000X | Transportation Broker | — | NULL | Yes |

## Other

- **Enumeration date:** 09/02/2020
- **Last updated:** 09/02/2020