Organization
HAMILTON ANCILLARY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE BROWN (ADMINISTRATOR)
(937) 291-7850
Entity
Organization
Contact information
Practice address
3000 MACK RD, FAIRFIELD, OH 45014-5335
(937) 291-7850
(937) 291-2962
Mailing address
PO BOX 750430, DAYTON, OH 45475-0430
(800) 742-2368
(937) 291-2962
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0527139
—
OH
Enumeration date
02/07/2006
Last updated
08/22/2020
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