Organization
SURGICAL ASSOCIATES OF GREENE COUNTY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA MCELDOWNEY (OFFICE MANAGER)
(937) 372-1602
Entity
Organization
Contact information
Practice address
244 WILSON DR, XENIA, OH 45385-1864
(937) 372-1602
(937) 372-0154
Mailing address
244 WILSON DR, XENIA, OH 45385-1864
(937) 372-1602
(937) 372-0154
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
S2-278069
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02193117
NY MEDICAID
NY
05
—
0976225
—
OH
01
—
110019187
MEDICARE RAILROAD
OH
05
—
2449
—
OH
01
—
65928137
KY MEDICAID
KY
01
—
D47861
CHOICECARE HUMANA
OH
Enumeration date
05/31/2006
Last updated
08/18/2008
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